EHA 2025 | The feasibility and safety of venetoclax-based regimens in octogenarian patients with CLL

This is a heavily difficult-to-treat population because we are dealing with very elderly patients, sometimes with several comorbidities. We were able to collect data from 120 patients who were more than 80 years old when they started treatment. Half of the patients were treatment-naive, but half of them were heavily treated patients. We were able to demonstrate that, thanks to a collaboration with Italian colleagues, that the majority of very elderly patients are able to receive venetoclax. We are able to complete the ramp-up phases. In one out of three patients, they need more than the classical five weeks to reach the full doses of the drugs; one out of three patients need to decrease the dose of the drug, but instead of stopping the drug, if you decrease the dose of the drugs, you are able to experience very, very long-term remission in this very elderly population. The treatment was very feasible, yes, in terms of adverse events. We reported a very low rate of adverse events in this elderly population, and if we excluded death due to progression or Richter syndrome transformation or death related to SARS-CoV-2 infections, we were able to demonstrate that the death related to treatment-related adverse events was about 15%. So again, suggesting that also very elderly patients can be treated safely with a venetoclax-based approach.

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