Recommandations of the Societe Francaise des Cancers de l’Enfant (SFCE) for the Management of Tumors Lysis Syndrom (TLS) : A Validation Survey.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5295-5295
Author(s):  
Y. Bertrand ◽  
A. Auvrignon ◽  
B. Nelken ◽  
V. Mialou ◽  
F. Mechinaud ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Creatinine ◽  
Acid Concentration ◽  
Lymphoblastic Leukemia ◽  
Urate Oxidase ◽  
Uric Acid Concentration ◽  
Plasma Uric Acid ◽  
Non Hodgkin Lymphoma ◽  
Metabolic Complication ◽  
Oxidase Enzyme

Abstract TLS is a frequent metabolic complication of hematologic malignant diseases which can generate important renal impairment. As described in previous studies (Goldman S.C. et al, Blood2001;97, 2998–3003 and Pui C.H. et al., J.Clin.Oncol.2001;19, 697–704), there are High Risk (HR) patients (pts) of TLS. Rasburicase a recombinant urate oxidase enzyme transforms uric acid into the highly soluble compound allantoin which is then excreted by the kidneys. Rasburicase is highly effective in prevention and treatment of TLS. Based on these studies, the SFCE made the following recommandations for the management of TLS in children. HR pts are defined as : B cell Acute Lymphoblastic Leukemia (ALL), ALL or Acute Myeloblastic Leukemia (AML) with initial leukocyte count of at least 50x109/L, Stage III and IV T or B Non Hodgkin Lymphoma (NHL), any leukemia or NHL with a plasma uric acid concentration of at least 300 mmoles/L if <10 years old or 350 mmoles/L if >10 years old, serum creatinine or lactate deshydrogenase concentration (LDH) exciding twice the upper limit of normal (N), hyperphosphatemia ≥2mmoles/L. These pts are treated by hyperhydratation (3L/m2) ±alkaline and Rasburicase 0,20 mg/kg/d x 5days. Rasburicase is carried on if serum creatinine > 1,5N or phosphatemia >3mmoles/L or plasma uric acid concentration ≥200mmoles/L and until normalization. Low Risk (LR) pts are defined as pts not HR. They are treated by hyperhydratation (3L/m2) and Rasburicase 0,20 mg/kg/d for one day only. Rasburicase is carried on during 4 days or more on the same biological basis as HR pts. In order to check the validity of those guidelines, we are conducting a survey looking at the evolution of the pts managed according to the SFCE recommandations.150 pts are planned for a 6 months study. On July 30th, 39 pts are registred : 25 ALL, 6 AML, 8 NHL (3 Burkitt). At that time there is no SLT complication. Results will be presented at the 2004 ASH Meeting.

SFCE (Societe Francaise des Cancers de l’Enfant) Recommendations for the Management of Tumor Lysis Syndrome (TLS): A Validation Survey.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3122-3122
Author(s):  
Yves Bertrand ◽  
Anne Auvrignon ◽  
Brigitte Nelken ◽  
Valérie Mialoux ◽  
Francoise Mechinaud ◽  
...  
Keyword(s):  
Uric Acid ◽  
Group Treatment ◽  
Treatment Guidelines ◽  
Tumor Lysis Syndrome ◽  
Urate Oxidase ◽  
Uric Acid Concentration ◽  
Prospective Survey ◽  
Non Hodgkin Lymphoma ◽  
Metabolic Complication ◽  
Group A

Abstract TLS is a metabolic complication of haematological malignancies, which can translate in renal impairment. As previously described (Goldman S.C. et al,Blood2001; 972998–3003 and Pui C.H.et al., J.Clin.Oncol.2001;19,697–704), some patients are at High Risk (HR) of developing TLS. Rasburicase (R) a recombinant urate oxidase which transforms uric acid into a highly soluble compound, allantoin, more easily excreted by the kidneys, is highly effective in the prevention and treatment of TLS. SFCE has made recommendations for the management of TLS in children and developed a prospective survey in order to validate these recommendations. Patients and Methods: HR pts were defined as: Acute Lymphoblastic (ALL) or Myeloblastic (AML) Leukaemia with initial leucocytes counts of at least 50x109/L, B cell ALL, Stage III and IV T or B Non Hodgkin Lymphoma (NHL), any leukaemia or NHL with a plasma uric acid concentration (U) of at least 300mmoles/L if ≤ 10 years old or 350mmoles/L if ≥ 10 years old, or any disease with serum creatinine (C) or lactate deshydrogenase concentration (LDH) exceeding twice the upper limit of normal (N), hyperphosphatemia (P)≥ 2 mmoles/L. These pts received hydration (3L/m2) ± alkalinization and R 0,20 mg/kg/d x 5 days. If C >1,5 N or P> 3mmoles/L or U ≥ 200mmoles/l, R administration is prolonged until normalization. Low risk (LR) pts, defined as not HR, received hydration 3L/m2 and R 0,20 mg/kg/for only one day. R could be prolonged according to the same criteria as HR pts. Results: Between May and December 2004, 174 patients including 91 boys and 83 girls (median age 5 years) were treated according to these recommendations, in 8 centers in France. Initial diagnosis was LA in141 and NHL in 33. 143 patients (82%) were classified HR and 31 LR (18%). In the HR group, the patients received a median of 5 days of treatment with R (1–12) and in the LR group a median of 1 day (0–5). 25% of HR patients required treatment prolongation, while the LR group treatment prolongation was needed for 1 patient (3%). No complication of TLS was observed. Conclusions: these results show that the risk classification as established by the SFCE was accurate and that the treatment guidelines was effective for the control of hyperuricemia and TLS.

Effect and Mechanism of Total Saponin of Dioscorea on Animal Experimental Hyperuricemia

2006 ◽  
Vol 34 (01) ◽  
pp. 77-85 ◽  
Author(s):  
Guang-Liang Chen ◽  
Wei Wei ◽  
Shu-Yun Xu
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Acid Concentration ◽  
Serum Uric Acid Level ◽  
Urate Oxidase ◽  
Uric Acid Concentration ◽  
Total Saponin ◽  
Test Kit ◽  
Serum Uric Acid Concentration ◽  
Potassium Oxonate

In this study, we investigated the effects and mechanisms of Total Saponin of Dioscorea (TSD) on animal experimental hyperuricemia. Mouse and rat hyperuricemic models were made by orally administering yeast extract paste once a day (30 and 20 g/kg, respectively), for 7 days. Yeast would disturb normal purine metabolism by increasing xanthine oxidase (XOD) activity and generating large quantities of uric acid. This model is similar to human hyperuricemia, which is induced by high-protein diets, due to a purine and nucleic acid metabolic disturbance. Another mouse hyperuricemia model was generated by intraperitoneal injection once with uric acid 250 mg/kg or potassium oxonate 300 mg/kg. Potassium oxonate, a urate oxidase inhibitor, can raise the serum uric acid level by inhibiting the decomposition of uric acid. Likewise, injecting uric acid can also increase serum uric acid concentration. The concentration of uric acid in serum or urine was detected by the phosphotungstic acid method, and the activity of XOD was assayed by a test kit. The results showed that TSD (240, 120 and 60 mg/kg, ig) could significantly lower the level of serum uric acid in hyperuricemic mice. TSD (120 and 60 mg/kg, ig) could also lower the level of serum uric acid in hyperuricemic rats, reduce the activity of XOD in the serum and liver of hyperuricemic rats, and increase the level of urine uric acid concentration as well as 24-hour total uric acid excretion. In conclusion, TSD possesses a potent anti-hyperuricemic effect on hyperuricemic animals, and the mechanism may be relevant in accelerating the excretion and decreasing the production of uric acid.

Acarbose alleviates rise in plasma uric acid concentration induced by sucrose ingestion

2008 ◽  
Vol 46 (04) ◽  
pp. 187-192 ◽  
Author(s):  
Y. Moriwaki ◽  
T. Kobayashi ◽  
T. Inokuchi ◽  
A. Yamamoto ◽  
S. Takahashi ◽  
...  
Keyword(s):  
Uric Acid ◽  
Acid Concentration ◽  
Uric Acid Concentration ◽  
Plasma Uric Acid

scholarly journals Effect of Betaine on Hepatic and Renal Functions in Acrylamide Treated Rats.

2019 ◽  
Vol 43 (1) ◽  
pp. 138-147
Author(s):  
Sadiq Jaffer Ramadhan
Keyword(s):  
Uric Acid ◽  
Serum Creatinine ◽  
Protective Effect ◽  
Acid Concentration ◽  
Treated Group ◽  
Renal Tissue ◽  
Female Rats ◽  
Control Group ◽  
Uric Acid Concentration ◽  
Functional Changes

This study was designed to evaluate the ameliorative role of betaine on hepatic and renal dysfunction caused by acrylamide in female rats. Thirty two (32) adult female rats were randomly and equally divided into four groups (G1, G2, G3 and G4) and were treated for (65) days as following: Group G1 (Control group), G2: rats were intubated 250mg/kg B.W of betaine; animals in group G3 were intubated 1mg/kg B.W of acrylamide, in addition to acrylamide. 250mg/kg B.W of betaine were administered orally to rats in groups G4. Fasting (8-12 hrs.) blood samples were collected by cardio puncture technique at the end of the experiment, serum were collected for measuring the following parameters A: liver enzyme makers; serum activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP)  B; renal function parameters including: serum creatinine, urea and uric acid concentration. The hepato and renal protective effect of betaine was clarified in groups (G2 and G4) manifested by significant decrease in serum, ALT, AST and ALP activity, as well as  significant decrease in serum creatinine, urea and uric acid concentration comparing to acrylamide (G3) treated group. Such functional changes were accompanied with structural (histopathological) alteration in hepatic and renal tissue. In conclusion, the results of the current study documented the negative effect of acrylamide on liver and kidney function and documented hepatorenal protective effect of betaine.

scholarly journals Quercetin lowers plasma uric acid in pre-hyperuricaemic males: a randomised, double-blinded, placebo-controlled, cross-over trial

2016 ◽  
Vol 115 (5) ◽  
pp. 800-806 ◽  
Author(s):  
Yuanlu Shi ◽  
Gary Williamson
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Urinary Excretion ◽  
Acid Concentration ◽  
Fasting Glucose ◽  
Uric Acid Concentration ◽  
Elevated Plasma ◽  
Plasma Uric Acid ◽  
Double Blinded ◽  
Healthy Males

AbstractElevated plasma uric acid concentration is a risk factor for gout, insulin resistance and type 2 diabetes. Quercetin, a flavonoid found in high levels in onions, tea and apples, inhibits xanthine oxidoreductasein vitro, the final step in intracellular uric acid production, indicating that quercetin might be able to lower blood uric acid in humans. We determined the effects of 4 weeks of oral supplementation of quercetin on plasma uric acid, blood pressure and fasting glucose. This randomised, double-blinded, placebo-controlled, cross-over trial recruited twenty-two healthy males (19–60 years) with baseline plasma uric acid concentration in the higher, but still considered healthy, range (339 (sd51) µmol/l). The intervention included one tablet containing 500 mg quercetin daily for 4 weeks, compared with placebo, with a 4-week washout period between treatments. The primary outcome was change in concentrations of plasma uric acid after 2 and 4 weeks; secondary outcome measures were changes in fasting plasma glucose, 24-h urinary excretion of uric acid and resting blood pressure. After quercetin treatment, plasma uric acid concentrations were significantly lowered by −26·5 µmol/l (95 % CI, −7·6, −45·5;P=0·008), without affecting fasting glucose, urinary excretion of uric acid or blood pressure. Daily supplementation of 500 mg quercetin, containing the bioavailable amount of quercetin as present in approximately 100 g red onions, for 4 weeks, significantly reduces elevated plasma uric acid concentrations in healthy males.

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