Evaluation of an interdisciplinary venetoclax initiation process in minimizing risk of tumor lysis syndrome

Venetoclax is a BCL-2 inhibitor approved for treatment of adult patients with chronic lymphocytic leukemia (CLL). Due to significant risk of tumor lysis syndrome (TLS) upon treatment initiation, a 5-week dose ramp-up is recommended. University of North Carolina Medical Center (UNCMC) utilizes a nove...

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Bibliographic Details
Published in:Leukemia & lymphoma 2022-07, Vol.63 (8), p.1831-1838
Main Authors: Cozad, Monica, Stump, Sarah E., Buhlinger, Kaitlyn, Collins, James, Muir, Michele, Coombs, Catherine C., Muluneh, Benyam
Format: Article
Language:English
Subjects:
CLL
Pharmacist
real-world data
tumor lysis syndrome
venetoclax
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Summary:Venetoclax is a BCL-2 inhibitor approved for treatment of adult patients with chronic lymphocytic leukemia (CLL). Due to significant risk of tumor lysis syndrome (TLS) upon treatment initiation, a 5-week dose ramp-up is recommended. University of North Carolina Medical Center (UNCMC) utilizes a novel interdisciplinary model of care involving clinical pharmacists (CPs) who oversee the 5-week ramp-up to minimize treatment-related adverse events. The aim of this study was to investigate the effects of a pharmacist-led venetoclax initiation protocol on patient outcomes. The primary objective was to determine the incidence of venetoclax-induced TLS during dose ramp-up in patients managed by a CP. In this cohort (n = 39), there were no cases of TLS during the venetoclax ramp-up. Reduced TLS rates were observed in CP-managed real-world patients compared to previous real-world reports. This real-world analysis supports the utilization of CPs for intensive monitoring of patients initiated on venetoclax.
ISSN:1042-8194
1029-2403
DOI:10.1080/10428194.2022.2047963