Tumor lysis, adverse events, and dose adjustments in 297 venetoclax-treated CLL patients in routine clinical practice Journal Article
| Authors: | Roeker, L. E.; Fox, C. P.; Eyre, T. A.; Brander, D. M.; Allan, J. N.; Schuster, S. J.; Nabhan, C.; Hill, B. T.; Shah, N. N.; Lansigan, F.; Yazdy, M.; Cheson, B. D.; Lamanna, N.; Singavi, A. K.; Coombs, C. C.; Barr, P. M.; Skarbnik, A. P.; Shadman, M.; Ujjani, C. S.; Tuncer, H. H.; Winter, A. M.; Rhodes, J.; Dorsey, C.; Morse, H.; Kabel, C.; Pagel, J. M.; Williams, A. M.; Jacobs, R.; Goy, A.; Muralikrishnan, S.; Pearson, L.; Sitlinger, A.; Bailey, N.; Schuh, A.; Kirkwood, A. A.; Mato, A. R. |
| Article Title: | Tumor lysis, adverse events, and dose adjustments in 297 venetoclax-treated CLL patients in routine clinical practice |
| Abstract: | Purpose: Clinical trials of venetoclax reported negligible imaging prior to venetoclax initiation. Clinical TLS occurred rates of clinical tumor lysis syndrome (TLS) in patients with in 2.7% of patients and laboratory TLS occurred in 5.7%. chronic lymphocytic leukemia (CLL) when using an extended Pre-venetoclax TLS risk group and creatinine clearance inde-dose escalation schedule. We aimed to understand TLS pro-pendently predict TLS development in multivariable anal-phylaxis, rates of select adverse events (AE), and impact of ysis. Grade 3/4 AEs included neutropenia (39.6%), throm-dosing modifications in routine clinical practice. bocytopenia (29.2%), infection (25%), neutropenic fever Experimental Design: This retrospective cohort study (7.9%), and diarrhea (6.9%). Twenty-two patients (7.4%) included 297 CLL venetoclax-treated patients outside of clin-discontinued venetoclax due to an AE. Progression-free ical trials in academic and community centers. Demographics, survival was similar regardless of number of dose interrup-baseline disease characteristics, venetoclax dosing, TLS risk tions, length of dose interruption, and stable venetoclax and prophylaxis, and AEs were collected. dose. Results: The group was 69% male, 96% had relapsed/ Conclusions: These data provide insights into current use of refractory CLL, 45% had deletion chromosome 17p, 84% venetoclax in clinical practice, including TLS rates observed in had unmutated IGHV, 80% received venetoclax monother-clinical practice. We identified opportunities for improved apy, and median age was 67. TLS risk was categorized as low adherence to TLS risk stratification and prophylaxis, which (40%), intermediate (32%), or high (28%), and 62% had may improve safety. © 2019 American Association for Cancer Research. |
| Journal Title: | Clinical Cancer Research |
| Volume: | 25 |
| Issue: | 14 |
| ISSN: | 1078-0432 |
| Publisher: | American Association for Cancer Research |
| Date Published: | 2019-07-15 |
| Start Page: | 4264 |
| End Page: | 4270 |
| Language: | English |
| DOI: | 10.1158/1078-0432.Ccr-19-0361 |
| PUBMED: | 31004001 |
| PROVIDER: | scopus |
| PMCID: | PMC8020996 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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