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Rasburicase vs. allopurinol: mortality in hematological malignancies post anti-hyperuricemic therapy - real-world
Mitchell Stuart Cairo1, Jack Ray Gallagher2, Yvonne Barnes3
1Departments of Pediatrics, Medicine, Pathology, Microbiology and Immunology and Cell Biology and Anatomy, Maria Fareri Children's Hospital Westchester Medical Center (WMC), New York Medical College, 40 Sunshine Cottage Road, Valhalla, 10595, NY, USA. Mitchell_Cairo@NYMC.EDU.
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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