What are key monitoring guidelines for patients with chronic lymphocytic leukemia (CLL) being treated with venetoclax (Venclexta)? — Name withheld on request

Chronic lymphocytic leukemia is one of the most common leukemic diagnoses in the United States. Treatment is based on the presence of cytochrome abnormalities specific to deletion of 17p [del(17p)]. del(17p) is a reflection of the loss of TP53 gene expression and is a prognostic indicator of response to chemotherapy and disease control.

Venetoclax, a BCL-2 inhibitor, is the first drug granted FDA approval for the treatment of del(17p) CLL in patients who have received at least one prior therapy. The drug is given in a ramp-up dose administration. With this administration method, patients are subject to a significant and rapid reduction in tumor burden that can result in tumor lysis syndrome (TLS). Therefore, TLS prophylaxis with close monitoring of blood chemistries and CBC are crucial to managing the care of these patients. Other supportive measures can include aggressive hydration and hyperuricemic management. — Jiajoyce R. Conway, DNP, CRNP, AOCNP

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Reference

Borg MA, Clemmons A. Venetoclax: a novel treatment for patients with del(17p) chronic lymphocytic leukemia. J Adv Pract Oncol. 2017;8:647-652.