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A retrospective analysis of tumor lysis syndrome management in a quaternary care hospital.
J Oncol Pharm Pract 2019; :1078155219846949JO

Abstract

PURPOSE

Due to an increased use of rasburicase, the study's purpose was to evaluate both the management of tumor lysis syndrome and the utilization of rasburicase in the hospital system. Additionally, the efficacy of flat dose rasburicase in lowering uric acid levels was evaluated. Based on the study's findings, the investigators will evaluate the usefulness of implementing a tumor lysis syndrome order set.

METHODS

This study evaluated patients from January 2013 through December 2016 for the rasburicase dose and the tumor lysis syndrome therapy administered.

RESULTS

Overall, 251 patients were included: prophylactic rasburicase group (n = 125) vs. treatment rasburicase group (n = 126) and of rasburicase 3 mg (R3) group (n = 168) vs. 6 mg (R6) group (n = 83). The prophylactic rasburicase vs. treatment rasburicase group had a significantly lower rate of receiving a xanthine oxidase inhibitor (48.0% vs. 64.3%, p = 0.009), a phosphate binder (6.4% vs. 17.5%, p = 0.007) and an additional dose of rasburicase (20.8% vs. 41.3%, p = 0.001). Intravenous hydration was neither significantly different between the rasburicase groups (p = 0.399) nor between the two rasburicase dosing groups (p = 0.874). Between the rasburicase dosing groups, there was no significant difference in the rate of receiving a xanthine oxidase inhibitor (p = 0.521) or a phosphate binder (p = 0.390). R6 patients had a significantly greater reduction in uric acid change compared to R3 patients (median = -7.9 (-10.1, -5.5) vs. -4.3 (-6.0, -2.7), p < 0.0001). There was no significant difference in uric acid change between the prophylactic rasburicase and treatment rasburicase groups (p = 0.875).

CONCLUSION

The study's findings justified the need to implement a tumor lysis syndrome order set. In the study population, utilizing a flat dosing method was effective for hyperuricemia.

Authors+Show Affiliations

1 PGY1 Pharmacy Resident, Hackensack University Medical Center, Hackensack, USA.2 Department of Clinical Health Professions, College of Pharmacy and Health Sciences, St. John's University, Queens, USA. 3 Division of Medical Oncology and Hematology Northwell Health Cancer Institute Donald & Barbara Zucker School of Medicine at Hofstra/Northwell Lake Success, NY.4 Biostatistics Unit, Feinstein Institute for Medical Research, Manhasset, USA.3 Division of Medical Oncology and Hematology Northwell Health Cancer Institute Donald & Barbara Zucker School of Medicine at Hofstra/Northwell Lake Success, NY.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31088218

Citation

Eng, Stephen, et al. "A Retrospective Analysis of Tumor Lysis Syndrome Management in a Quaternary Care Hospital." Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners, 2019, p. 1078155219846949.
Eng S, Lee CS, Ahn S, et al. A retrospective analysis of tumor lysis syndrome management in a quaternary care hospital. J Oncol Pharm Pract. 2019.
Eng, S., Lee, C. S., Ahn, S., & Sharma, A. (2019). A retrospective analysis of tumor lysis syndrome management in a quaternary care hospital. Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners, p. 1078155219846949. doi:10.1177/1078155219846949.
Eng S, et al. A Retrospective Analysis of Tumor Lysis Syndrome Management in a Quaternary Care Hospital. J Oncol Pharm Pract. 2019 May 14;1078155219846949. PubMed PMID: 31088218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A retrospective analysis of tumor lysis syndrome management in a quaternary care hospital. AU - Eng,Stephen, AU - Lee,Chung-Shien, AU - Ahn,Seungjun, AU - Sharma,Amy, Y1 - 2019/05/14/ PY - 2019/5/16/entrez KW - Rasburicase KW - allopurinol KW - flat dose KW - hyperuricemia KW - tumor lysis syndrome SP - 1078155219846949 EP - 1078155219846949 JF - Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners JO - J Oncol Pharm Pract N2 - PURPOSE: Due to an increased use of rasburicase, the study's purpose was to evaluate both the management of tumor lysis syndrome and the utilization of rasburicase in the hospital system. Additionally, the efficacy of flat dose rasburicase in lowering uric acid levels was evaluated. Based on the study's findings, the investigators will evaluate the usefulness of implementing a tumor lysis syndrome order set. METHODS: This study evaluated patients from January 2013 through December 2016 for the rasburicase dose and the tumor lysis syndrome therapy administered. RESULTS: Overall, 251 patients were included: prophylactic rasburicase group (n = 125) vs. treatment rasburicase group (n = 126) and of rasburicase 3 mg (R3) group (n = 168) vs. 6 mg (R6) group (n = 83). The prophylactic rasburicase vs. treatment rasburicase group had a significantly lower rate of receiving a xanthine oxidase inhibitor (48.0% vs. 64.3%, p = 0.009), a phosphate binder (6.4% vs. 17.5%, p = 0.007) and an additional dose of rasburicase (20.8% vs. 41.3%, p = 0.001). Intravenous hydration was neither significantly different between the rasburicase groups (p = 0.399) nor between the two rasburicase dosing groups (p = 0.874). Between the rasburicase dosing groups, there was no significant difference in the rate of receiving a xanthine oxidase inhibitor (p = 0.521) or a phosphate binder (p = 0.390). R6 patients had a significantly greater reduction in uric acid change compared to R3 patients (median = -7.9 (-10.1, -5.5) vs. -4.3 (-6.0, -2.7), p < 0.0001). There was no significant difference in uric acid change between the prophylactic rasburicase and treatment rasburicase groups (p = 0.875). CONCLUSION: The study's findings justified the need to implement a tumor lysis syndrome order set. In the study population, utilizing a flat dosing method was effective for hyperuricemia. SN - 1477-092X UR - https://www.unboundmedicine.com/medline/citation/31088218/A_retrospective_analysis_of_tumor_lysis_syndrome_management_in_a_quaternary_care_hospital L2 - http://journals.sagepub.com/doi/full/10.1177/1078155219846949?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -