ASH 2025 | Evaluation of real-world ventoclax initiation prophylaxis & monitoring outcomes in patients with CLL

So, this is a very important topic. Venetoclax initiation can be sometimes, you know, difficult in the community setting because of the intensive tumor lysis monitoring, which is needed for patients. But what we did is in a cohort of patients from a database called CORE, we had 155 patients from six participating sites who initiated venetoclax plus obinutuzumab outside of a clinical trial. And we looked at different things, like we looked at their tumor burden category, low, medium, or high. And we also looked at, you know, the incidence of laboratory or clinical tumor lysis syndrome, if it occurred during the Venetoclax initiation phase. So then we also looked at interventions which were given for these patients. So we found that most patients when they started venetoclax were in the low tumor burden range. And then there was no laboratory or clinical TLS which occurred in the venetoclax ramp-up of the 110 patients, 24 of them received an intervention followed by blood monitoring test. And all interventions received were confirmed then to be prophylactic or non-TLS related. So the most common intervention was prophylactic hydration. We know that venetoclax, people should hydrate really well. Sometimes it’s oral hydration, but we often give sometimes IV fluids. So I think this was very consistent with what has been seen in other studies, like in prospective trials, like the CLL14 trial, where there was no TLS reported during Venetoclax ramp-up in this real-world setting as well. So I think this is good data, which gives us more information about monitoring and prophylaxis in a real-world setting.

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