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December 8, 2025BloodOpen Access

Impact of angiotensin converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARB) on tumor lysis syndrome, acute kidney injury, and rasburicase use in patients undergoing chemotherapy for hematologic malignancies

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Authors

EPEmily Pack

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Overview

Analysis shows higher tumor lysis syndrome and acute kidney injury risk with ACEi/ARB in patients receiving chemotherapy for hematologic malignancies, indicating a need for careful use.

Key Points

  • Higher incidence of acute kidney injury was observed in patients receiving ACE inhibitors and ARBs, at 7.8% vs 5.0% in controls, suggesting significant risk.
  • Among 17,583 matched patients, tumor lysis syndrome developed in 1.9% of those with ACEi/ARB compared to 1.3% without, highlighting safety concerns.
  • Utilization of rasburicase was notably increased in the ACEi/ARB group at 3.1%, pointing to the adverse effects of these medications during treatment.
  • The findings underscore the importance of evaluating the risks versus benefits of ACE inhibitors and ARBs in high-risk cancer patients.

Cite This Study

Emily Pack (2025) studied this question.

synapsesocial.com/papers/69362f3d4fa91c937236d4ebhttps://doi.org/10.1182/blood-2025-4527
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) on kidney functions in allogeneic stem cell transplant patients receiving tacrolimus2025
  2. 2Comparative effectiveness of antihypertensive drug classes in patients with gastrointestinal malignancy and incident hypertension.2026
  3. 3A comparative analysis of ACE Inhibitors and ARBs as cancer risk factors2026
  4. 4Tumor-specific risk of acute kidney injury: A multi-cancer comparison across matched real-world cohorts2025
  5. 5Comparative cardiovascular outcomes of renin–angiotensin system inhibitors in patients receiving maintenance hemodialysis: a large real-world cohort study2026 · 1 citations