This information is about a drug called rasburicase, which is given alongside chemotherapy for leukaemia or lymphoma. It is used to prevent or treat a side effect of chemotherapy called tumour lysis syndrome.
We hope this information answers your questions. If you have any further questions you can ask the doctor, nurse or pharmacist at the hospital where you are having your treatment.
Rasburicase is given before and during chemotherapy for some types of leukaemia and lymphoma. It can help reduce the risk of tumour lysis syndrome.
Tumour lysis syndrome (TLS) is a complication that can be caused by some chemotherapy drugs. It's more common in cancers that grow quickly and respond quickly to chemotherapy, such as acute leukaemias and high-grade lymphomas. People with other types of cancer are rarely affected by TLS.
To understand TLS, it helps to know how chemotherapy works. Chemotherapy works by killing cancer cells. As the cancer cells break down, they release a chemical called uric acid, which is cleared from the body by the kidneys. When high numbers of cancer cells are destroyed very quickly, the kidneys can't cope with the increase in uric acid. This leads to imbalances in some chemicals in the blood (phosphate, potassium and calcium), which can cause more serious problems affecting the kidneys and the heart. TLS is the term used to describe these abnormally high chemical imbalances.
Rasburicase changes uric acid so that it can be easily processed and removed from the body by the kidneys. This prevents a build up of uric acid.
How rasburicase is given
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Rasburicase is given before or during the start of your chemotherapy treatment.
It is given by drip (infusion) into a vein through a fine tube called a cannula, or through a central or PICC line. The infusion is given over 30 minutes, once a day, for up to seven days. Your doctors will decide how many days of treatment you need by taking regular blood tests to check the level of uric acid in your blood.
You will also be given large amounts of fluids through a line into your bloodstream (called intravenous hydration) to help flush through your kidneys.
Possible side effects of rasburicase
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Each person’s reaction to any medication is different. Most people have very few side effects, while others may experience more. The side effects described here won't affect everyone who is having rasburicase and may be different if you are having more than one drug.
We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your nurse or doctor.
Your nurses and doctors will monitor your temperature during treatment with chemotherapy and rasburicase. Signs of a high temperature can include feeling hot and sweaty or feeling cold and shivery. It's important to let the nurses or doctors know if you feel you have a high temperature.
Some people have an allergic reaction to rasburicase. Signs of this can include itching, a rash, feeling short of breath and, less commonly, chest pain. Tell your nurse or doctor straight away if you have any of these symptoms so that if you are having a reaction, it can be treated quickly.
This is uncommon and can usually be easily controlled with medicine, but tell your doctor if it is severe or persistent. It's important to drink plenty of fluids if you have diarrhoea.
These are uncommon. It is important to drink plenty of fluids. Let your doctor know if you have a headache, as medication can be prescribed.
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Rasburicase shouldn't be given to anyone who has the metabolic disorder known as Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Some medicines can be harmful to take when you are having cancer treatment. Let your doctor know about any medication you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
This section has been compiled using information from a number of reliable sources, including:
Coiffier B, et al. Guidelines for the Management of Pediatric and Adult Tumour Lysis Syndrome: An evidence-based review. Journal of Clinical Oncology. 2008. 26: 16, 2767–78.
electronic Medicines Compendium (eMC). www.medicines.org.uk (accessed October 2012).
Souhami, Hochhaser. Cancer and its Management. 6th edition. 2010. Wiley-Blackwell.
Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
Thank you to Professor Rajnish Gupta, Consultant Medical Oncologist, and the people affected by cancer who reviewed this edition. Reviewing information is just one of the ways you could help when you join our Cancer Voices network.