| Consensus conference on the management of tumor lysis syndrome. | |
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MedLine Citation:
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PMID: 18838473 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. 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. The current article reports the recommendations on the management of tumor lysis syndrome that were issued during a Consensus Conference project, and which were endorsed by the Italian Society of Hematology (SIE), the Italian Association of Pediatric Oncologists (AIEOP) and the Italian Society of Medical Oncology (AIOM). Current concepts on the pathophysiology, clinical features, and therapy of tumor lysis syndrome were evaluated by a Panel of 8 experts. A consensus was then developed for statements regarding key questions on tumor lysis syndrome management selected according to the criterion of relevance by group discussion. 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. 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. Methodologically rigorous studies are needed to clarify its cost-effectiveness profile. |
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Authors:
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Patrizia Tosi; Giovanni Barosi; Carlo Lazzaro; Vincenzo Liso; Monia Marchetti; Enrica Morra; Andrea Pession; Giovanni Rosti; Antonio Santoro; Pier Luigi Zinzani; Sante Tura |
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Publication Detail:
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Type: Consensus Development Conference; Journal Article; Practice Guideline Date: 2008-10-06 |
Journal Detail:
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Title: Haematologica Volume: 93 ISSN: 1592-8721 ISO Abbreviation: Haematologica Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-03 Completed Date: 2009-02-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: Italy |
Other Details:
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Languages: eng Pagination: 1877-85 Citation Subset: IM |
Affiliation:
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Hematology Unit, Istituto Seragnoli, Ospedale Sant'Orsola Malpighi, Bologna, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Allopurinol
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therapeutic use Disease Management Hematologic Neoplasms / complications Humans Italy Tumor Lysis Syndrome / drug therapy* Urate Oxidase / therapeutic use |
| Chemical | |
Reg. No./Substance:
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315-30-0/Allopurinol; EC 1.7.3.3/Urate Oxidase; EC 1.7.3.3./rasburicase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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