Rasburicase Versus Allopurinol in Tumor Patients at Risk for Hyperuricemia and Tumor Lysis Syndrome

Inclusion Criteria

• •1. Meets high risk or at potential risk for tumor lysis syndrome (TLS):
• •A patient is at high risk for TLS if he/she presents with:
• •* Hyperuricemia of malignancy (plasma uric acid \> 7.5 mg/dL);
• •* A diagnosis of very aggressive lymphoma/leukemia based on the Revised European-American Lymphoma (REAL) classification of lymphoma/leukemia;
• •* Acute myeloid leukemia (AML);
• •* Chronic myeloid leukemia (CML) in blast crisis; or
• •* High grade myelodysplastic syndrome (refractory anemia with excess blast, chronic myelomonocytic leukemia, and refractory anemia with excess blast in transformation) only if they have \> 10% bone marrow blast involvement and are given aggressive treatment similar to AML.
• •A patient is at potential risk for TLS if he/she presents with:
• •* A diagnosis of aggressive lymphoma/leukemia based on the REAL classification of lymphoma/leukemia plus 1 or more of the following criteria:
• •* Lactate dehydrogenase (LDH) \>= 2 x upper limit of normal (ULN) (IU/L)
• •* Stage III-IV disease
• •* Stage I-II disease with at least 1 lymph node/tumor \> 5 cm in diameter
• •In addition to the above-mentioned eligibility criteria, the patients should have the following criteria:
• •2. Eastern Cooperative Oncology Group (ECOG) performance status 0-3
• •3. Age \>= 18 years
• •4. Life expectancy \> 3 months
• •5. Negative pregnancy test (females of child bearing potential) and use of effective contraceptive method (for both males and females). A pregnancy test may be performed on serum or urine human chorionic gonadotropin (HCG).
• •6. Signed written informed consent