Tumor lysis syndrome (TLS) has been shown to infrequently occur in treatment of chronic lymphocytic leukemia (CLL) using venetoclax with sufficient dose escalation. Recently, researchers analyzed real-world patterns of TLS and other outcomes with venetoclax for patients with CLL and reported their findings in Clinical Cancer Research.

Infrequently occur in treatment

In this multicenter, retrospective cohort analysis base on chart reviews, treatment patterns and outcomes are examine for 297 patients with CLL give venetoclax in clinical practice in the United States and the United Kingdom. Patients are group by baseline TLS risk.

Most patients (96%) had relapsed or refractory CLL. Chromosome 17p deletion is present in 45% of patients, 84% had unmutat IGHV, and 47% showed a creatinine clearance of less than 80 mL/min. TLS risk is consider high for 28% of patients, intermediate for 32%, and low for 40%. Most patients (80%) are treat with venetoclax monotherapy.

Laboratory TLS was present in 5.7% of patients; 2.7% of patients experienced clinical TLS. Of the 25 instances of TLS observed, 10 occurred in patients in the high-risk category, 10 in intermediate-risk patients, and 5 in low-risk patients. TLS forced permanent discontinuation of venetoclax for 1 patient and was associated with 1 fatality following venetoclax reinitiation without dose escalation.

Patients experienced clinical

The researchers found that many patients were misclassified for TLS risk. Both higher TLS risk and low creatinine clearance were significantly associated with development of TLS. Because TLS occurred among 14.7% of patients with a creatinine clearance below 80 mL/min and 5.0% of those with a higher creatinine clearance (P =.02).

The most common grade 3 or 4 adverse events reported were neutropenia (39.6%), thrombocytopenia (29.2%), and infection (25%). Toxicity was the reason for 19.3% of discontinuations. Because Progression-free survival appeared unaffected by venetoclax dose reductions or interruptions.

The authors noted that TLS is more prevalent in this analysis than in clinical trials, but stated, “with improve attention to accurate risk classification and adherence to recommend TLS prophylaxis strategies, rates of TLS may be further reduce, likely translating to better patient outcomes.”In CLL, too many blood stem cells become abnormal lymphocytes and do not become healthy white blood cells.

Blood and bone marrow

The abnormal lymphocytes may also be call leukemia cells. The lymphocytes are not able to fight infection very well. Also, as the number of lymphocytes increases in the blood and bone marrow; therefore there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding.
Anything that increases your risk of getting a disease is call a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Because Talk with your doctor if you think you may be at risk. Risk factors for CLL include the following: