Emerging role of rasburicase in the management of increased plasma uric acid levels in patients with hematologic malignancies

LeAnne D Kennedy1 Susannah Koontz2 Kamakshi Rao31Wake Forest University Baptist Medical Center, Winston Salem, NC, USA; 2Koontz Oncology Consulting LLC, Houston, TX, USA; 3UNC Hospitals, Chapel Hill, NC, USAAbstract: Tumor lysis syndrome (TLS) is defined as a group of metabolic derangements that result from the massive and abrupt release of cellular components into the bloodstream after rapid lysis of tumor cells. Breakdown of released materials leads to a number of electrolyte abnormalities, including elevated uric acid concentrations in the blood (hyperuricemia), which carries potentially serious consequences. The diagnosis, prevention, and management of TLS is complicated by variability in definitions, differences in risk factors based on patient- and tumor-specific characteristics, and practitioner preferences in terms of pharmaceutical management strategies. The best prevention and management option for a particular patient depends on the patient’s baseline risk for TLS development, the severity of symptoms in the event of TLS development, practical management considerations, and financial implications of treatment.Keywords: tumor lysis syndrome, uric acid, rasburicaseA Letter to the Editor has been received and published for this article.