{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:47:03Z","timestamp":1782751623992,"version":"3.54.5"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rasburicase is a high-cost medicine indicated for the prevention and treatment of tumour lysis syndrome (TLS). Growing evidence supports low fixed-dose rasburicase regimens (3\u20136\u2005mg), however, uncertainty remains regarding their ability to prevent progression to clinical TLS, particularly in high-risk populations. Some institutions implement medicine governance strategies, such as a medicines formulary, to optimise safe, effective, and economical use through specific criteria, risk stratification and dosing stipulations, to facilitate appropriate prescribing. This study aimed to evaluate biochemical TLS (BTLS) and clinical TLS (CTLS) outcomes with rasburicase and characterise compliance with institutional prescribing criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, single-centre, observational study was conducted of adults with haematologic malignancies who received at least one dose of rasburicase between March 2017 and March 2025. Rasburicase indication, dosing, TLS outcomes, and compliance with prescribing criteria were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of the 144 patients, 114\/144 (79%) were high-risk for TLS and 99\/144 (69%) received rasburicase prophylactically. Fixed low-doses predominated, with 61% receiving a single dose. Urate normalisation within 24\u2005h occurred in 92% of all patients and 97% of prophylaxis patients. Despite rapid biochemical response, 47\/99 (47%) of prophylaxis patients demonstrated LTLS and 14\/99 (14%) developed CTLS, where 9\/14 (64%) had pre-existing kidney impairment. Prescribing criteria compliance was 85%, with non-compliance primarily attributed to early biochemical changes or urgent need for anti-cancer therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study confirmed the clinical and economic validity of low fixed-dose rasburicase for TLS prophylaxis in high- and intermediate-risk patients and TLS treatment, while demonstrating high compliance with institutional prescribing criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552261459597","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:04:26Z","timestamp":1782453866000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low fixed dose rasburicase for tumour lysis syndrome prophylaxis and treatment is feasible and efficacious in the management of haematologic malignancies"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5050-9919","authenticated-orcid":false,"given":"Taylor","family":"Mackie","sequence":"first","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"School of Pharmacy and Pharmaceutical Sciences, The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Tobin","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien","family":"Chan","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7620-0076","authenticated-orcid":false,"given":"Michael","family":"Whordley","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"School of Pharmacy and Pharmaceutical Sciences, The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Luo","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Winckel","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"School of Pharmacy and Pharmaceutical Sciences, The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Dunsdon","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9223-0740","authenticated-orcid":false,"given":"Marissa","family":"Ryan","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"School of Pharmacy and Pharmaceutical Sciences, The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05094.x"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S103864"},{"key":"e_1_3_2_4_2","first-page":"2767","article-title":"Guidelines for the management of pediatric and adult tumor Lysis syndrome","volume":"26","author":"Coiffier B","year":"2008","unstructured":"Coiffier B, Altman A, Pui CH, et al. Guidelines for the management of pediatric and adult tumor Lysis syndrome. An Evidence-Based Review. J Clin Oncol 2008; 26: 2767\u20132778.","journal-title":"An Evidence-Based Review. J Clin Oncol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13403"},{"key":"e_1_3_2_6_2","unstructured":"Sanofi-Aventis Australia Pty L. Fasturtec (rasburicase) product information. Canberra (AU). 2003. Updated 13 Dec 2023. https:\/\/www.ebs.tga.gov.au\/ebs\/picmi\/picmirepository.nsf\/pdf?OpenAgent&id=CP-2010-PI-05607-3&d=20250313172310101."},{"key":"e_1_3_2_7_2","unstructured":"Queensland H. Rasburicase (Fasturtec\u00ae) prescribing and administration guide. [cited 2025 Feb 17] https:\/\/www.health.qld.gov.au\/__data\/assets\/pdf_file\/0028\/443665\/rasburicase-guide.pdf."},{"key":"e_1_3_2_8_2","unstructured":"Queensland H. List of approved medicines: Rasburicase injection 1.5\u2005mg. Accessed 03\/07\/2024. Queensland Health List of Approved Medicines (qlam.com.au)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.04.115"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr490"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/10781552211021147"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1078155219851543"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/10781552221087978"},{"key":"e_1_3_2_14_2","unstructured":"Anz D. Pharmacy management. Updated October 12 2025. Accessed Nov 03. https:\/\/www.dedalus.com\/anz\/our-offer\/products\/pharmacy-management\/."},{"key":"e_1_3_2_15_2","unstructured":"Our Oncology Solution: Charm Evolution\u00ae: OIMS. Magentus. Updated 02\/06\/2023. Accessed Nov 03. https:\/\/www.magentus.com\/clinical-systems\/oncology\/?r=a#modules."},{"key":"e_1_3_2_16_2","unstructured":"iMDsoft. Patient data management system for ICU. Updated June 2025; 04. https:\/\/imd-soft.com\/metavision\/icu\/. 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