Leukocytosis Medication

Updated: May 19, 2020
  • Author: Susumu Inoue, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
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Medication

Medication Summary

Hyperleukocytosis in leukemia is often complicated by a tumor lysis syndrome, which includes a high serum uric acid and uric acid nephropathy. Prompt measures to reduce serum uric acid and prevent uric acid nephropathy are required.

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Uric acid inhibitors

Class Summary

These drugs are used to prevent acute uric acid nephropathy associated with leukocytosis in myeloproliferative disease and leukemia.

Allopurinol (Aloprim, Zyloprim)

Inhibits xanthine oxidase, the enzyme that synthesizes uric acid from hypoxanthine. Reduces synthesis of uric acid without disrupting biosynthesis of vital purines. Reduces plasma concentration and urine excretion of uric acid; simultaneously increases plasma concentration and urine excretion of more soluble oxypurine precursors.

Rasburicase (Elitek)

Recombinant form of urate oxidase (derived from Saccharomyces cerevisiae -synthesized Aspergillus flavus), which oxidizes uric acid to allantoin (soluble and inactive). Indicated for treatment and prophylaxis of severe hyperuricemia associated with treatment of malignancy. Hyperuricemia causes precipitant in kidneys, leading to acute renal failure. Unlike uric acid, allantoin soluble and easily excreted by kidneys. Elimination half-life is 18 h.

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