Clinical Relevance of Intensive Laboratory Monitoring With Standard Venetoclax Ramp-Up for Chronic Lymphocytic Leukemia: A Real-World Experience.

Autor:	Huang IJ; Department of Pharmacy, UW Medicine, Seattle, WA.; Department of Pharmacy, Fred Hutchinson Cancer Center, Seattle, WA., Baek GT; Department of Pharmacy, UW Medicine, Seattle, WA.; Department of Pharmacy, Fred Hutchinson Cancer Center, Seattle, WA., Cohen J; Department of Pharmacy, UW Medicine, Seattle, WA.; Department of Pharmacy, Fred Hutchinson Cancer Center, Seattle, WA., Khajaviyan S; Department of Research, Fred Hutchinson Cancer Center, Seattle, WA., Louie S; Department of Hematology and Hematologic Malignancies, Fred Hutchinson Cancer Center, Seattle, WA., Samples L; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Smith SD; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Till BG; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Warren EH; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Gopal AK; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Poh C; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Lynch RC; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Ujjani CS; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Shadman M; Division of Hematology and Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2024 Nov 18, pp. OP2400416. Date of Electronic Publication: 2024 Nov 18.
DOI:	10.1200/OP.24.00416
Abstrakt:	Purpose: Venetoclax is the standard of care for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) but requires intensive monitoring for optimal safety. Clinical relevance of intensive monitoring in practice is unknown, especially for patients with low or intermediate risk for tumor lysis syndrome (TLS). Patients and Methods: A retrospective review was conducted to determine clinical significance of monitoring for TLS during standard ramp-up for patients with CLL/SLL. Patients receiving abbreviated ramp-up, clinical trials, or concurrent Bruton tyrosine kinase inhibitors were excluded. The primary end point was TLS incidence, with secondary end points describing associated clinical interventions. Results: Fifty-five patients met study criteria. The majority of patients received venetoclax as first-line therapy (58%), with anti-CD20 antibody therapy (82%), and were at low risk of TLS (75%). No clinical TLS events occurred, whereas laboratory TLS occurred in only 1.8% of patients. No patients required antihyperuricemic therapy, and few interventions for hyperphosphatemia or hypocalcemia (3.6% of patients) were required. Additional intravenous fluids were uncommonly required (1.8% of patients), and no unplanned hospitalizations were required. Conclusion: These findings support efforts to reduce intensive monitoring requirements during venetoclax ramp-up for patients with CLL, potentially increasing accessibility of venetoclax.
Databáze:	MEDLINE
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