Elitek (rasburicase) / Sanofi - LARVOL DELTA

Retrospective Evaluation of Fixed-Dose Rasburicase (3 mg vs. 6 mg) for Uric Acid Normalization in Tumor Lysis Syndrome (HOPA 2026) - "Data will be extracted from the electronic health record, including demographics, malignancy type, baseline labs, chemotherapy administration, and allopurinol exposure. 3 mg rasburicase demonstrated comparable effectiveness to 6 mg in achieving uric acid normalization. 3 mg fixed-dose group saved approximately $70,000, while 6 mg saved about $224,000 with a total cost savings of $294,000 with fixed-dosing."

Retrospective data • Metabolic Disorders • Oncology

Biochemical deciphering of an Atypical methemoglobinemia. (PubMed, Pract Lab Med) - "This case highlights the laboratory's role in identifying such abnormalities and the importance of clinician-laboratory awareness regarding rasburicase-induced methemoglobinemia. It also suggests the necessity of G6PD screening prior to rasburicase administration whenever possible."

Journal • Hematological Disorders • Hematological Malignancies • Leukemia • Metabolic Disorders • Oncology

Tumor lysis syndrome in children with hematological malignancies: a nephrology perspective in resource-limited settings. (PubMed, Front Oncol) - "In pediatric TLS, AKI severity is the main determinant of clinical outcome. Dynamic phosphate kinetics (Delta phosphorus), rather than static biochemical thresholds, represent a robust early biomarker for identifying children at risk of severe AKI and may improve risk stratification, particularly in resource-limited settings."

Journal • Acute Kidney Injury • Acute Lymphocytic Leukemia • Burkitt Lymphoma • Chronic Kidney Disease • Critical care • Hematological Disorders • Hematological Malignancies • Leukemia • Lymphoma • Metabolic Disorders • Nephrology • Oncology • Pediatrics • Renal Disease

TUMOUR LYSIS SYNDROME IN ACUTE LEUKEMIA: THE ROLE OF EARLY RENAL REPLACEMENT THERAPY (ISN-WCN 2026) - "She received IV dexamethasone 4 mg and IV rasburicase 3 mg while on oxygenation support for respiratory distress...She was also started on allopurinol 300 mg daily along with aggressive hydration.Results Despite optimal medical therapy, her potassium level rose to 7.1 mmol/L with persistent TLS features...CVVHDF provides effective and stable correction of refractory electrolyte disturbances while maintaining hemodynamic stability. Multidisciplinary collaboration among oncology, nephrology, and critical care teams is essential to achieve optimal patient outcomes."

Acute Kidney Injury • Acute Lymphocytic Leukemia • CNS Disorders • Endocrine Disorders • Epilepsy • Hematological Malignancies • Hepatology • Infectious Disease • Leukemia • Lymphoma • Metabolic Disorders • Nephrology • Oncology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • T Acute Lymphoblastic Leukemia

SAVE (Safe Accelerated Venetoclax Escalation): Initial results of a prospective, phase Ib study of venetoclax with an accelerated dose ramp-up in patients with CLL. (ASCO 2023) - P1 | "19 pts received obinutuzumab with VEN, and 1 pt received VEN monotherapy...One pt with medium TLS risk had lab TLS (phos and uric acid peaked at 8.7 mg/dL) after the first VEN 400 mg dose, which resolved with sevelamer and rasburicase, thereby prolonging the ramp-up to 6 days... Our early data suggest that an inpatient, accelerated 5-day VEN ramp-up is feasible in CLL, with a low rate of TLS, even among patients with medium or high risk of TLS. The study is currently ongoing. Clinical trial information: NCT04843904."

Clinical • P1 data • Chronic Lymphocytic Leukemia • Hematological Disorders • Neutropenia • Thrombocytopenia

Efficacy of Rasburicase in the Management of Acute Kidney Injury with Associated Hyperuricemia (PAS 2026) - No abstract available

Clinical • Acute Kidney Injury • Nephrology • Renal Disease

Real-world safety of rasburicase in patients with refractory chronic gouty arthritis:a retrospective observations study (EULAR 2026) - No abstract available

Real-world • Real-world evidence • Retrospective data • Immunology • Inflammatory Arthritis • Rheumatology

Rapidly Evolving AKI after CAR-T therapy: A Case for Clinical Vigilance and Timely Renal Support (NKF-SCM 2026) - "METHODS/CASE SUMMARY A 34-year-old male diagnosed with B-cell acute lymphoblastic leukemia (B-ALL) with relapse was admitted for CAR-T therapy with brexucabtagene autoleucel...Four doses of tocilizumab and dexamethasone were given for neurotoxicity...Rasburicase and allopurinol were given due to concern for TLS...Clinicians must maintain high clinical vigilance with close and proactive monitoring of AKI and prompt response. Early initiation of renal replacement therapy in this clinical setting may provide both organ support and mitigate inflammation-related injury."

Clinical • Acute Kidney Injury • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • CNS Disorders • Hematological Malignancies • Hypotension • Leukemia • Nephrology • Renal Disease

SJS-TEN With Shock and Tumor Lysis Syndrome in a Patient With Angioimmunoblastic T-Cell Lymphoma (SCCM 2026) - "Diagnosis and management become more complex in immunocompromised patients with multiorgan failure or oncologic comorbidities.Description: A 72-year-old man with newly diagnosed angioimmunoblastic T-cell lymphoma developed fever, rash, and hypotension one week after completing a 10-day course of oral levofloxacin for a groin seroma at the site of a prior lymph node biopsy. He was admitted to the ICU for hemodynamic instability requiring vasopressors and intravenous hydrocortisone...Tumor lysis syndrome (TLS) developed secondary to steroids (uric acid >9 mg/dL), managed with rasburicase...Transfer to burn centers may not be possible when BSA slough is limited ( < 10%) or overall prognosis is poor. ICU teams should maintain a high index of suspicion for drug-induced SJS-TEN, balance immunosuppression with renal risk, and involve palliative services early in multisystem disease."

Clinical • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hypotension • Immunology • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Renal Disease • Steven-Johnson Syndrome • T Cell Non-Hodgkin Lymphoma

Testicular Pain and Swelling as Initial Sign of Desmoplastic Small Round Cell Tumor in Adolescent (SCCM 2026) - "He had clinical and laboratory findings consistent with tumor lysis syndrome (TLS) and acute kidney injury (AKI), initially treated with hyperhydration, rasburicase and allopurinol. ACS has also been linked to DSRCT, typically occurring in patients with extensive intra-abdominal disease or rapid tumor progression. It is essential to consider malignancy as a differential diagnosis of testicular pain and ensure close follow-up for complete symptom resolution."

Acute Kidney Injury • Back Pain • Cardiovascular • Hypertension • Musculoskeletal Pain • Nephrology • Oncology • Pain • Peritoneal Cancer • Renal Disease • Sarcoma • Soft Tissue Sarcoma • Solid Tumor

Clinical Features and Outcomes of Spontaneous Tumor Lysis in Testicular Germ Cell Tumors: A Case Series From a Cancer Center in Lahore, Pakistan. (PubMed, Cureus) - "Management included aggressive intravenous hydration, urate-lowering therapy with rasburicase and/or allopurinol, and renal replacement therapy for refractory metabolic disturbances...Tumor burden appears to be a key risk factor regardless of histological subtype. Increased clinical awareness, early diagnosis, aggressive supportive care, and tailored chemotherapy approaches are critical to reducing morbidity and mortality in this high-risk population."

Journal • Acute Kidney Injury • Endocrine Disorders • Germ Cell Tumors • Metabolic Disorders • Nephrology • Oncology • Renal Disease • Solid Tumor • Testicular Cancer • Testicular Seminoma

APHP191099: RASBU-SEPSIS Study: Effects of rasburicase on kidney during sepsis a randomized, placebo-controlled, double-blind trial (clinicaltrialsregister.eu) - P2/3 | N=240 | Not yet recruiting | Sponsor: Assistance Publique Hopitaux De Paris

New P2/3 trial • Critical care • Infectious Disease • Metabolic Disorders • Septic Shock

A Case of Spontaneous Tumor Lysis Syndrome in a Patient with Malignant Thymoma (NKF-SCM 2026) - "Given the electrolyte derangements, oliguria, and lack of approval for rasburicase administration, she underwent hemodialysis for three consecutive days...CONCLUSION This case illustrates a rare but clinically significant presentation of spontaneous tumor lysis- like syndrome and uric acid-mediated acute kidney injury in a patient with metastatic thymoma. Early recognition and prompt management are essential for optimal outcomes."

Clinical • Acute Kidney Injury • Atrial Fibrillation • Cardiovascular • CNS Disorders • Myasthenia Gravis • Nephrology • Oncology • Renal Disease • Solid Tumor • Thymoma • Thymus Cancer

A Cure That Cuts Too Deep: Recognizing Rapid Hemolysis After Rasburicase (NKF-SCM 2026) - "He was initiated on cyclophosphamide for debulking cytoreduction despite no tissue diagnosis of the mass. During active hemolysis the number of reticulocytes increases, and they have higher levels of G6PD than mature RBCs. High WBC counts can also overestimate G6PD levels in assays using whole blood."

Cardiovascular • CNS Disorders • Diabetes • Fibrosis • Heart Failure • Hematological Disorders • Hematological Malignancies • Hepatology • Hypertension • Immunology • Infectious Disease • Lymphoma • Metabolic Disorders • Nephrology • Renal Disease • G6PD • HP

Tubule's Role in Tumor Lysis Syndrome (NKF-SCM 2026) - "Due to concerns for TLS and anuria, he was immediately initiated on hemodialysis and rasburicase, with clinical improvement...Such patients should receive aggressive hydration before initiating cancer therapy. While Montesinos and Prasertan models exist for TLS risk prediction for AML and pediatric leukemia respectively, there is a need for developing risk stratification scores for other cancer types, including kidney function as a criterion, to reduce the incidence of such cases."

Back Pain • Chronic Kidney Disease • CNS Disorders • Epilepsy • Hematological Malignancies • Leukemia • Metabolic Disorders • Multiple Myeloma • Musculoskeletal Pain • Nephrology • Oncology • Plasmacytoma • Renal Disease

Rasburicase-Induced Methemoglobinemia in an Acutely Hypoxic Patient: A Case Report (ATS 2026) - No abstract available

Case report • Clinical • Hematological Disorders

Complete Renal Recovery After Spontaneous Tumor Lysis Syndrome in Myelofibrosis-Transformed Acute Myeloid Leukemia (NKF-SCM 2026) - "RESULTS/CASE DISCUSSION Management included aggressive intravenous hydration, rasburicase, and cytoreduction with hydroxyurea/leukapheresis...Decitabine was started for an accelerated-phase myeloproliferative neoplasm (MPN)...A high clinical suspicion is warranted in patients with AKI and metabolic disturbances, even without a known active malignancy. Early recognition and aggressive management with coordinated multidisciplinary approach, including dialysis for metabolic crises, prompt use of rasburicase, are essential to reduce mortality and morbidity, enabling potential full recovery."

Acute Kidney Injury • Acute Myelogenous Leukemia • Febrile Neutropenia • Hematological Malignancies • Leukemia • Metabolic Disorders • Myelofibrosis • Myeloproliferative Neoplasm • Nephrology • Oncology • Renal Disease • JAK2 • TP53

A Rare Case of Acute Hemolysis After Rasburicase Infusion. (PubMed, J Adv Pract Oncol) - "Exposure to certain medications such as rasburicase, sulfonamides, nitrofurantoin, antimalarials, dapsone, chloramphenicol, high-dose aspirin, methylene blue, and phenazopyridine may trigger a hemolytic crisis in those with G6PD deficiency. Tests used in the diagnosis of HA include the Coombs test, haptoglobin, complete blood count, urinalysis, lactate dehydrogenase, bone marrow tests, and a peripheral blood smear. This article summarizes the case of a patient who developed HA after an infusion of rasburicase and offers management strategies."

Journal • Cardiovascular • Fatigue • Hematological Disorders • Infectious Disease • Metabolic Disorders • G6PD • HP

Acute Hemolytic Anemia Following Rasburicase in a Very Late Post-Transplant Relapse of Acute Myeloid Leukemia. (PubMed, Mediterr J Hematol Infect Dis) - No abstract available

Journal • Acute Myelogenous Leukemia • Anemia • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • Transplantation

A Phase 2 Study of Minimal Residual Disease (MRD)-Adapted Front Line Venetoclax and Obinutuzumab in Fit Patients with Chronic Lymphocytic Leukemia (CLL): Effect of Obinutuzumab on Tumor Lysis Syndrome (TLS) Risk and Safety of Outpatient Venetoclax Dose Escalation (ASH 2023) - P2 | "For pts who remained high TLS risk at the time of V initiation, TLS ppx throughout dose escalation included allopurinol to start at least 3 days prior to V initiation, sevelamer to start 12 hours prior to V initiation, and oral intake of ≥2 L water daily. On days of dose escalation, ppx additionally included kayexalate, rasburicase, and IV normal saline on D1 and D2 of each dose escalation... A single cycle of O effectively reduced TLS risk prior to introduction of V escalation with most pts achieving low or med TLS risk by C1D22. Notably, 90% of pts with high pre-tx TLS risk converted to low or med risk following C1 of O allowing for outpatient V escalation per FDA label. Further, we demonstrate that V dose escalation can be safely accomplished in the outpatient setting with close monitoring regardless of TLS risk."

Clinical • Minimal residual disease • P2 data • Residual disease • Chronic Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • Oncology • Thrombocytopenia

Concurrent tumor lysis syndrome and 5-fluorouracil encephalopathy during the first cycle of zolbetuximab plus mFOLFOX6 for CLDN18.2-positive gastric cancer: a case report. (PubMed, Int Cancer Conf J) - "Discontinuation of 5-FU and supportive care consisting of hydration and rasburicase led to rapid clinical improvement. Chemotherapy, which was resumed after a dosage adjustment, achieved tumor shrinkage and resolved the hydronephrosis. To the best of our knowledge, the present study is the first to describe concurrent TLS and 5-FU-induced encephalopathy during the administration of a zolbetuximab-based regimen and highlights the need for proactive prophylaxis against TLS and for controlling nausea in AGC patients with a high tumor burden, baseline renal impairment, and cachexia."

Journal • Cachexia • CNS Disorders • Gastric Cancer • Nephrology • Oncology • Peritoneal Cancer • Renal Disease • Solid Tumor • CLDN18 • HER-2

Continuous hemodiafiltration during chemotherapy for acute kidney injury in spontaneous tumor lysis syndrome due to high-grade B-cell lymphoma: a case report. (PubMed, CEN Case Rep) - "Rasburicase was given once on hospital day 12...Switching to CHDF to sustainably correct hyperuricemia and electrolyte abnormalities resulted in favorable renal outcomes without complications. Although evidence regarding the efficacy of CHDF against TLS-induced AKI remains very limited, we suggest that management with CHDF for AKI in STLS or TLS is reasonable to prevent TLS aggravation during chemotherapy and to avert renal toxicity from the chemotherapy itself."

Journal • Acute Kidney Injury • B Cell Lymphoma • Fatigue • Hematological Disorders • Hematological Malignancies • High-grade B-cell lymphoma • Lymphoma • Metabolic Disorders • Nephrology • Non-Hodgkin’s Lymphoma • Oncology • Renal Disease

Research progress on multidimensional intervention strategies for hyperuricemia: Western medicine, Traditional Chinese Medicine, and emerging therapies. (PubMed, Front Endocrinol (Lausanne)) - "This article systematically reviews the current various intervention methods and research status for the treatment of hyperuricemia: In the field of Western medicine, it deeply analyzes the efficacy, mechanism of action, and clinical limitations of drugs that promote uric acid excretion (such as benzbromarone and dotinurad), drugs that inhibit uric acid synthesis (such as allopurinol, febuxostat, and topiroxostat), and drugs that promote uric acid hydrolysis (such as pegloticase and rasburicase). It focuses on elaborating the research breakthroughs of URAT1 inhibitor derivatives and the new drug SHR4640...At the same time, it details the action pathways and clinical evidence of emerging therapies such as SGLT2 inhibitors, the GLP-1/GCG dual-receptor agonist Mazdutide, probiotics, and washed microbiota transplantation (WMT). By summarizing mechanistic insights, clinical progress, and translational prospects, this review aims to inform the development of individualized and..."

Journal • Review • Cardiovascular • Gout • Inflammatory Arthritis • Metabolic Disorders • Rheumatology • Transplantation • GCG

Not Available (PubMed, AMB Express) - "Comparative molecular dynamics simulations with rasburicase indicated that, based on RMSF, radius of gyration (Rg), and hydrogen-bond counts, TC1-Uox2 adopts a more compact overall structure...These findings elucidate the structural basis of its enhanced thermostability. In summary, TC1-Uox2 is a high-activity, high-stability uricase candidate that represents a promising enzyme target for biotherapeutic intervention in hyperuricemia and illustrates the translational potential of extreme-environment metagenomics for metabolic disease applications."

Journal • Gout • Inflammatory Arthritis • Metabolic Disorders • Rheumatology

The Use of Single Dose of Rasburicase for the Prophylaxis and Treatment of Tumor Lysis Syndrome in Pediatric Patients: A Narrative Review. (PubMed, Hematol Rep) - " Single dose of rasburicase for the prophylaxis and treatment of TLS in pediatric oncology is an appealing approach with potentially less financial impact and drug toxicity. A fixed dose of at least 3 mg or 0.15 mg/kg by body weight is recommended."

Journal • Review • Acute Lymphocytic Leukemia • Burkitt Lymphoma • Hematological Malignancies • Leukemia • Lymphoma • Oncology • Pediatrics