Why is rasburicase contraindicated in G6PD deficiency?

Why is rasburicase contraindicated in G6PD deficiency?

Rasburicase itself does not cause hemolysis rather hydrogen peroxide, a byproduct of the enzymatic oxidation of uric acid into water-soluble allantoin by rasburicase, results in an oxidative stress to the erythrocytes and triggers hemolysis and methemoglobinemia in patients with G6PD deficiency.

What class of drug is rasburicase?

Rasburicase injection is in a class of medications called enzymes. It works by breaking down uric acid so that the body can eliminate it.

When do you give allopurinol after rasburicase?

5.2 After first dose of rasburicase, start allopurinol 300 mg/m2/day (or 10 mg/kg/day) PO divided TID. 2.1. 5.3 Give first dose of Rasburicase as soon as HR-TLS criteria for elevated uric acid are met, even if therapy is not to start immediately.

How much does Rasburicase cost?

It is worth noting that rasburicase treatment is expensive. A regimen of rasburicase in a 70-kg adult, dosed per manufacturer’s weight-based recommendation, costs an estimated $7500 for 1 day of therapy and $37,500 for 5 days of therapy.

When do you give Rasburicase for tumor lysis syndrome?

The first dose of rasburicase should be administered 4 to 24 hours before starting chemotherapy. Rasburicase is given as an intravenous infusion over 30 minutes and should not be given as a bolus infusion (4).

Can you give allopurinol with Rasburicase?

Association between rasburicase and allopurinol should be avoided, because the latter may reduce the effect of rasburicase owing to its inhibition of xanthine oxidase and consequent reduced uric acid concentration (Jeha and Pui 2005).

When is Rasburicase given?

What is Rasburicase and what is its role in the mitigation of TLS?

Rasburicase, a recombinant urate oxidase enzyme, is a new agent indicated in the treatment or prophylaxis of hyperuricemia in pediatric patients with cancer who are at high risk for TLS.

Should rasburicase be used as a prophylaxis for tumor lysis syndrome?

Hydration and rasburicase should also be administered to patients with clinical tumor lysis syndrome and to adults and high-risk children who develop laboratory tumor lysis syndrome. In conclusion, the Panel recommended rasburicase for tumor lysis syndrome prophylaxis in selected patients based on the drug efficacy profile.

Which medications are used to treat tumor lysis syndrome (TLS)?

Drugs that act on the metabolic pathway of uric acid to allantoin, like allopurinol or rasburicase, are effective for prophylaxis and treatment of tumor lysis syndrome. Sound recommendations should regulate diagnosis and drug application in the clinical setting.

What is the role of hydration and rasburicase in the treatment of cancer?

Hydration and rasburicase should be administered to adult cancer patients who are candidates for tumor-specific therapy and who carry a high risk of tumor lysis syndrome. Cancer patients with a low-risk of tumor lysis syndrome should instead receive hydration along with oral allopurinol.

What do we know about tumor lysis syndrome?

Consensus conference on the management of tumor lysis syndrome Tumor lysis syndrome is a potentially life threatening complication of massive cellular lysis in cancers. Identification of high-risk patients and early recognition of the syndrome is crucial in the institution of appropriate treatments.