NYMC Faculty Publications

Rasburicase vs. Allopurinol: Mortality in Hematological Malignancies Post Anti-Hyperuricemic Therapy - Real-World Study

Author Type(s)

Student

DOI

10.1007/s00520-025-10090-y

Journal Title

Supportive Care in Cancer

Document Type

Article

Publication Date

12-1-2025

Department

Pediatrics

Keywords

Hematological malignancy, Hyperuricemia (HUA), Liquid tumor, Propensity score (PS), Real-world (RW), Retrospective, Tumor lysis syndrome (TLS)

Disciplines

Medicine and Health Sciences

Abstract

Purpose: This retrospective, real-world (RW) study utilizing propensity score matching investigated tumor lysis syndrome (TLS)-related mortalities following anti-hyperuricemic (HU) monotherapy (allopurinol vs. rasburicase) in hematological malignancies. The study aim was to determine if a significant difference exists in the proportion of TLS-associated mortalities in hematological malignancy patients who received either rasburicase or allopurinol. Methods: Following random selection of patient cases of rasburicase or allopurinol monotherapy, 141 in each group were PS-matched for TLS risk using 11 predictive covariates. Results: Rasburicase-treated patients had significantly lower TLS-associated mortality (2.1% (n = 3) vs. 7.1% (n = 10) (p = 0.047)). Conclusions: Following successful PS matching of TLS-risk factors, this study suggests rasburicase statistically significantly reduces TLS-associated mortalities compared to allopurinol.

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