Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States.
Identifieur interne : 000666 ( Main/Exploration ); précédent : 000665; suivant : 000667Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States.
Auteurs : Anthony R. Mato ; Meghan Thompson [États-Unis] ; John N. Allan [États-Unis] ; Danielle M. Brander [États-Unis] ; John M. Pagel [États-Unis] ; Chaitra S. Ujjani [États-Unis] ; Brian T. Hill [États-Unis] ; Nicole Lamanna [États-Unis] ; Frederick Lansigan [États-Unis] ; Ryan Jacobs [États-Unis] ; Mazyar Shadman [États-Unis] ; Alan P. Skarbnik [États-Unis] ; Jeffrey J. Pu [États-Unis] ; Paul M. Barr [États-Unis] ; Alison R. Sehgal [États-Unis] ; Bruce D. Cheson [États-Unis] ; Clive S. Zent [États-Unis] ; Hande H. Tuncer [États-Unis] ; Stephen J. Schuster [États-Unis] ; Peter V. Pickens [États-Unis] ; Nirav N. Shah [États-Unis] ; Andre Goy [États-Unis] ; Allison M. Winter [États-Unis] ; Christine Garcia [États-Unis] ; Kaitlin Kennard [États-Unis] ; Krista Isaac [États-Unis] ; Colleen Dorsey [États-Unis] ; Lisa M. Gashonia [États-Unis] ; Arun K. Singavi [États-Unis] ; Lindsey E. Roeker [États-Unis] ; Andrew Zelenetz [États-Unis] ; Annalynn Williams [États-Unis] ; Christina Howlett [États-Unis] ; Hanna Weissbrot [États-Unis] ; Naveed Ali [États-Unis] ; Sirin Khajavian [États-Unis] ; Andrea Sitlinger [États-Unis] ; Eve Tranchito [États-Unis] ; Joanna Rhodes [États-Unis] ; Joshua Felsenfeld [États-Unis] ; Neil Bailey [États-Unis] ; Bhavisha Patel [États-Unis] ; Timothy F. Burns [États-Unis] ; Melissa Yacur [États-Unis] ; Mansi Malhotra [États-Unis] ; Jakub Svoboda [États-Unis] ; Richard R. Furman [États-Unis] ; Chadi Nabhan [États-Unis]Source :
- Haematologica [ 1592-8721 ] ; 2018.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse de survie (MeSH), Antinéoplasiques (administration et posologie), Antinéoplasiques (effets indésirables), Antinéoplasiques (usage thérapeutique), Composés hétérocycliques bicycliques (administration et posologie), Composés hétérocycliques bicycliques (effets indésirables), Composés hétérocycliques bicycliques (usage thérapeutique), Femelle (MeSH), Humains (MeSH), Leucémie chronique lymphocytaire à cellules B (diagnostic), Leucémie chronique lymphocytaire à cellules B (génétique), Leucémie chronique lymphocytaire à cellules B (mortalité), Leucémie chronique lymphocytaire à cellules B (traitement médicamenteux), Mâle (MeSH), Prise en charge de la maladie (MeSH), Protocoles de polychimiothérapie antinéoplasique (effets indésirables), Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique), Récidive (MeSH), Résistance aux médicaments antinéoplasiques (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Sulfonamides (administration et posologie), Sulfonamides (effets indésirables), Sulfonamides (usage thérapeutique), Syndrome de lyse tumorale (étiologie).
- MESH :
- administration et posologie : Antinéoplasiques, Composés hétérocycliques bicycliques, Sulfonamides.
- diagnostic : Leucémie chronique lymphocytaire à cellules B.
- effets indésirables : Antinéoplasiques, Composés hétérocycliques bicycliques, Protocoles de polychimiothérapie antinéoplasique, Sulfonamides.
- génétique : Leucémie chronique lymphocytaire à cellules B.
- mortalité : Leucémie chronique lymphocytaire à cellules B.
- traitement médicamenteux : Leucémie chronique lymphocytaire à cellules B.
- usage thérapeutique : Antinéoplasiques, Composés hétérocycliques bicycliques, Protocoles de polychimiothérapie antinéoplasique, Sulfonamides.
- étiologie : Syndrome de lyse tumorale.
- Adulte, Adulte d'âge moyen, Analyse de survie, Femelle, Humains, Mâle, Prise en charge de la maladie, Récidive, Résistance aux médicaments antinéoplasiques, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Antineoplastic Agents (administration & dosage), Antineoplastic Agents (adverse effects), Antineoplastic Agents (therapeutic use), Antineoplastic Combined Chemotherapy Protocols (adverse effects), Antineoplastic Combined Chemotherapy Protocols (therapeutic use), Bridged Bicyclo Compounds, Heterocyclic (administration & dosage), Bridged Bicyclo Compounds, Heterocyclic (adverse effects), Bridged Bicyclo Compounds, Heterocyclic (therapeutic use), Disease Management (MeSH), Drug Resistance, Neoplasm (MeSH), Female (MeSH), Humans (MeSH), Leukemia, Lymphocytic, Chronic, B-Cell (diagnosis), Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy), Leukemia, Lymphocytic, Chronic, B-Cell (genetics), Leukemia, Lymphocytic, Chronic, B-Cell (mortality), Male (MeSH), Middle Aged (MeSH), Recurrence (MeSH), Sulfonamides (administration & dosage), Sulfonamides (adverse effects), Sulfonamides (therapeutic use), Survival Analysis (MeSH), Treatment Outcome (MeSH), Tumor Lysis Syndrome (etiology).
- MESH :
- chemical , administration & dosage : Antineoplastic Agents, Bridged Bicyclo Compounds, Heterocyclic, Sulfonamides.
- chemical , adverse effects : Antineoplastic Agents, Bridged Bicyclo Compounds, Heterocyclic, Sulfonamides.
- chemical , therapeutic use : Antineoplastic Agents, Bridged Bicyclo Compounds, Heterocyclic, Sulfonamides.
- adverse effects : Antineoplastic Combined Chemotherapy Protocols.
- diagnosis : Leukemia, Lymphocytic, Chronic, B-Cell.
- drug therapy : Leukemia, Lymphocytic, Chronic, B-Cell.
- etiology : Tumor Lysis Syndrome.
- genetics : Leukemia, Lymphocytic, Chronic, B-Cell.
- mortality : Leukemia, Lymphocytic, Chronic, B-Cell.
- therapeutic use : Antineoplastic Combined Chemotherapy Protocols.
- Adult, Aged, Aged, 80 and over, Disease Management, Drug Resistance, Neoplasm, Female, Humans, Male, Middle Aged, Recurrence, Survival Analysis, Treatment Outcome.
Abstract
Venetoclax is a BCL2 inhibitor approved for 17p-deleted relapsed/refractory chronic lymphocytic leukemia with activity following kinase inhibitors. We conducted a multicenter retrospective cohort analysis of patients with chronic lymphocytic leukemia treated with venetoclax to describe outcomes, toxicities, and treatment selection following venetoclax discontinuation. A total of 141 chronic lymphocytic leukemia patients were included (98% relapsed/refractory). Median age at venetoclax initiation was 67 years (range 37-91), median prior therapies was 3 (0-11), 81% unmutated IGHV, 45% del(17p), and 26.8% complex karyotype (≥ 3 abnormalities). Prior to venetoclax initiation, 89% received a B-cell receptor antagonist. For tumor lysis syndrome prophylaxis, 93% received allopurinol, 92% normal saline, and 45% rasburicase. Dose escalation to the maximum recommended dose of 400 mg daily was achieved in 85% of patients. Adverse events of interest included neutropenia in 47.4%, thrombocytopenia in 36%, tumor lysis syndrome in 13.4%, neutropenic fever in 11.6%, and diarrhea in 7.3%. The overall response rate to venetoclax was 72% (19.4% complete remission). With a median follow up of 7 months, median progression free survival and overall survival for the entire cohort have not been reached. To date, 41 venetoclax treated patients have discontinued therapy and 24 have received a subsequent therapy, most commonly ibrutinib. In the largest clinical experience of venetoclax-treated chronic lymphocytic leukemia patients, the majority successfully completed and maintained a maximum recommended dose. Response rates and duration of response appear comparable to clinical trial data. Venetoclax was active in patients with mutations known to confer ibrutinib resistance. Optimal sequencing of newer chronic lymphocytic leukemia therapies requires further study.
DOI: 10.3324/haematol.2018.193615
PubMed: 29880613
PubMed Central: PMC6119152
Affiliations:
- États-Unis
- Caroline du Nord, District de Columbia, Massachusetts, New Hampshire, New Jersey, Ohio, Pennsylvanie, Washington (État), Wisconsin, État de New York
Links toward previous steps (curation, corpus...)
Le document en format XML
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<author><name sortKey="Zent, Clive S" sort="Zent, Clive S" uniqKey="Zent C" first="Clive S" last="Zent">Clive S. Zent</name>
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<author><name sortKey="Tuncer, Hande H" sort="Tuncer, Hande H" uniqKey="Tuncer H" first="Hande H" last="Tuncer">Hande H. Tuncer</name>
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<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Schuster, Stephen J" sort="Schuster, Stephen J" uniqKey="Schuster S" first="Stephen J" last="Schuster">Stephen J. Schuster</name>
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<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
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<author><name sortKey="Pickens, Peter V" sort="Pickens, Peter V" uniqKey="Pickens P" first="Peter V" last="Pickens">Peter V. Pickens</name>
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<author><name sortKey="Shah, Nirav N" sort="Shah, Nirav N" uniqKey="Shah N" first="Nirav N" last="Shah">Nirav N. Shah</name>
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<author><name sortKey="Goy, Andre" sort="Goy, Andre" uniqKey="Goy A" first="Andre" last="Goy">Andre Goy</name>
<affiliation wicri:level="2"><nlm:affiliation>John Theurer Cancer Center, Hackensack Meridian Health, NJ, USA.</nlm:affiliation>
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<author><name sortKey="Winter, Allison M" sort="Winter, Allison M" uniqKey="Winter A" first="Allison M" last="Winter">Allison M. Winter</name>
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<placeName><region type="state">Ohio</region>
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<author><name sortKey="Garcia, Christine" sort="Garcia, Christine" uniqKey="Garcia C" first="Christine" last="Garcia">Christine Garcia</name>
<affiliation wicri:level="2"><nlm:affiliation>University of Pittsburgh Medical Center, PA, USA.</nlm:affiliation>
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<wicri:regionArea>University of Pittsburgh Medical Center, PA</wicri:regionArea>
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<author><name sortKey="Kennard, Kaitlin" sort="Kennard, Kaitlin" uniqKey="Kennard K" first="Kaitlin" last="Kennard">Kaitlin Kennard</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Isaac, Krista" sort="Isaac, Krista" uniqKey="Isaac K" first="Krista" last="Isaac">Krista Isaac</name>
<affiliation wicri:level="2"><nlm:affiliation>Internal Medicine, Lankenau Medical Center, Wynnewood, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Internal Medicine, Lankenau Medical Center, Wynnewood, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dorsey, Colleen" sort="Dorsey, Colleen" uniqKey="Dorsey C" first="Colleen" last="Dorsey">Colleen Dorsey</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gashonia, Lisa M" sort="Gashonia, Lisa M" uniqKey="Gashonia L" first="Lisa M" last="Gashonia">Lisa M. Gashonia</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Singavi, Arun K" sort="Singavi, Arun K" uniqKey="Singavi A" first="Arun K" last="Singavi">Arun K. Singavi</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Hematology & Oncology, Medical College of Wisconsin, Brookfield, WI, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Hematology & Oncology, Medical College of Wisconsin, Brookfield, WI</wicri:regionArea>
<placeName><region type="state">Wisconsin</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Roeker, Lindsey E" sort="Roeker, Lindsey E" uniqKey="Roeker L" first="Lindsey E" last="Roeker">Lindsey E. Roeker</name>
<affiliation wicri:level="2"><nlm:affiliation>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zelenetz, Andrew" sort="Zelenetz, Andrew" uniqKey="Zelenetz A" first="Andrew" last="Zelenetz">Andrew Zelenetz</name>
<affiliation wicri:level="2"><nlm:affiliation>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
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<author><name sortKey="Ali, Naveed" sort="Ali, Naveed" uniqKey="Ali N" first="Naveed" last="Ali">Naveed Ali</name>
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<wicri:regionArea>University of Washington/Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, WA</wicri:regionArea>
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<author><name sortKey="Sitlinger, Andrea" sort="Sitlinger, Andrea" uniqKey="Sitlinger A" first="Andrea" last="Sitlinger">Andrea Sitlinger</name>
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<placeName><region type="state">Caroline du Nord</region>
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<author><name sortKey="Tranchito, Eve" sort="Tranchito, Eve" uniqKey="Tranchito E" first="Eve" last="Tranchito">Eve Tranchito</name>
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<author><name sortKey="Rhodes, Joanna" sort="Rhodes, Joanna" uniqKey="Rhodes J" first="Joanna" last="Rhodes">Joanna Rhodes</name>
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<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
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<author><name sortKey="Bailey, Neil" sort="Bailey, Neil" uniqKey="Bailey N" first="Neil" last="Bailey">Neil Bailey</name>
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<author><name sortKey="Patel, Bhavisha" sort="Patel, Bhavisha" uniqKey="Patel B" first="Bhavisha" last="Patel">Bhavisha Patel</name>
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<wicri:regionArea>Washington Hospital Center, DC</wicri:regionArea>
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<author><name sortKey="Burns, Timothy F" sort="Burns, Timothy F" uniqKey="Burns T" first="Timothy F" last="Burns">Timothy F. Burns</name>
<affiliation wicri:level="2"><nlm:affiliation>Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.</nlm:affiliation>
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<wicri:regionArea>Dartmouth-Hitchcock Medical Center, Lebanon, NH</wicri:regionArea>
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<author><name sortKey="Yacur, Melissa" sort="Yacur, Melissa" uniqKey="Yacur M" first="Melissa" last="Yacur">Melissa Yacur</name>
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<wicri:regionArea>Penn State Health, Hershey, PA</wicri:regionArea>
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<author><name sortKey="Malhotra, Mansi" sort="Malhotra, Mansi" uniqKey="Malhotra M" first="Mansi" last="Malhotra">Mansi Malhotra</name>
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<wicri:regionArea>Tufts Medical Center, Boston, MA</wicri:regionArea>
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<author><name sortKey="Svoboda, Jakub" sort="Svoboda, Jakub" uniqKey="Svoboda J" first="Jakub" last="Svoboda">Jakub Svoboda</name>
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<author><name sortKey="Furman, Richard R" sort="Furman, Richard R" uniqKey="Furman R" first="Richard R" last="Furman">Richard R. Furman</name>
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<author><name sortKey="Nabhan, Chadi" sort="Nabhan, Chadi" uniqKey="Nabhan C" first="Chadi" last="Nabhan">Chadi Nabhan</name>
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<wicri:regionArea>Cardinal Health, Dublin, OH</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States.</title>
<author><name sortKey="Mato, Anthony R" sort="Mato, Anthony R" uniqKey="Mato A" first="Anthony R" last="Mato">Anthony R. Mato</name>
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<author><name sortKey="Thompson, Meghan" sort="Thompson, Meghan" uniqKey="Thompson M" first="Meghan" last="Thompson">Meghan Thompson</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
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<author><name sortKey="Allan, John N" sort="Allan, John N" uniqKey="Allan J" first="John N" last="Allan">John N. Allan</name>
<affiliation wicri:level="2"><nlm:affiliation>New York Presbyterian & Weill Cornell, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New York Presbyterian & Weill Cornell, NY</wicri:regionArea>
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<author><name sortKey="Brander, Danielle M" sort="Brander, Danielle M" uniqKey="Brander D" first="Danielle M" last="Brander">Danielle M. Brander</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
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<author><name sortKey="Pagel, John M" sort="Pagel, John M" uniqKey="Pagel J" first="John M" last="Pagel">John M. Pagel</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA, USA.</nlm:affiliation>
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<wicri:regionArea>Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA</wicri:regionArea>
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<author><name sortKey="Ujjani, Chaitra S" sort="Ujjani, Chaitra S" uniqKey="Ujjani C" first="Chaitra S" last="Ujjani">Chaitra S. Ujjani</name>
<affiliation wicri:level="2"><nlm:affiliation>Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC</wicri:regionArea>
<placeName><region type="state">District de Columbia</region>
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</author>
<author><name sortKey="Hill, Brian T" sort="Hill, Brian T" uniqKey="Hill B" first="Brian T" last="Hill">Brian T. Hill</name>
<affiliation wicri:level="2"><nlm:affiliation>Taussig Cancer Institute, Cleveland Clinic Foundation, OH, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Taussig Cancer Institute, Cleveland Clinic Foundation, OH</wicri:regionArea>
<placeName><region type="state">Ohio</region>
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<author><name sortKey="Lamanna, Nicole" sort="Lamanna, Nicole" uniqKey="Lamanna N" first="Nicole" last="Lamanna">Nicole Lamanna</name>
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<wicri:regionArea>Columbia University Medical Center, New York, NY</wicri:regionArea>
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<author><name sortKey="Lansigan, Frederick" sort="Lansigan, Frederick" uniqKey="Lansigan F" first="Frederick" last="Lansigan">Frederick Lansigan</name>
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<wicri:regionArea>Dartmouth-Hitchcock Medical Center, Lebanon, NH</wicri:regionArea>
<placeName><region type="state">New Hampshire</region>
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<author><name sortKey="Jacobs, Ryan" sort="Jacobs, Ryan" uniqKey="Jacobs R" first="Ryan" last="Jacobs">Ryan Jacobs</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC</wicri:regionArea>
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<author><name sortKey="Shadman, Mazyar" sort="Shadman, Mazyar" uniqKey="Shadman M" first="Mazyar" last="Shadman">Mazyar Shadman</name>
<affiliation wicri:level="2"><nlm:affiliation>University of Washington/Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, WA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Washington/Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, WA</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
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</author>
<author><name sortKey="Skarbnik, Alan P" sort="Skarbnik, Alan P" uniqKey="Skarbnik A" first="Alan P" last="Skarbnik">Alan P. Skarbnik</name>
<affiliation wicri:level="2"><nlm:affiliation>John Theurer Cancer Center, Hackensack Meridian Health, NJ, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center, Hackensack Meridian Health, NJ</wicri:regionArea>
<placeName><region type="state">New Jersey</region>
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</author>
<author><name sortKey="Pu, Jeffrey J" sort="Pu, Jeffrey J" uniqKey="Pu J" first="Jeffrey J" last="Pu">Jeffrey J. Pu</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Penn State Health, Hershey, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
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<author><name sortKey="Barr, Paul M" sort="Barr, Paul M" uniqKey="Barr P" first="Paul M" last="Barr">Paul M. Barr</name>
<affiliation wicri:level="2"><nlm:affiliation>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY</wicri:regionArea>
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<author><name sortKey="Sehgal, Alison R" sort="Sehgal, Alison R" uniqKey="Sehgal A" first="Alison R" last="Sehgal">Alison R. Sehgal</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Pittsburgh Medical Center, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
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<author><name sortKey="Cheson, Bruce D" sort="Cheson, Bruce D" uniqKey="Cheson B" first="Bruce D" last="Cheson">Bruce D. Cheson</name>
<affiliation wicri:level="2"><nlm:affiliation>Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC</wicri:regionArea>
<placeName><region type="state">District de Columbia</region>
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<author><name sortKey="Zent, Clive S" sort="Zent, Clive S" uniqKey="Zent C" first="Clive S" last="Zent">Clive S. Zent</name>
<affiliation wicri:level="2"><nlm:affiliation>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
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</affiliation>
</author>
<author><name sortKey="Tuncer, Hande H" sort="Tuncer, Hande H" uniqKey="Tuncer H" first="Hande H" last="Tuncer">Hande H. Tuncer</name>
<affiliation wicri:level="2"><nlm:affiliation>Tufts Medical Center, Boston, MA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Tufts Medical Center, Boston, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Schuster, Stephen J" sort="Schuster, Stephen J" uniqKey="Schuster S" first="Stephen J" last="Schuster">Stephen J. Schuster</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
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<author><name sortKey="Pickens, Peter V" sort="Pickens, Peter V" uniqKey="Pickens P" first="Peter V" last="Pickens">Peter V. Pickens</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Abington Hem. Onc. Assoc., Inc., Willow Grove, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
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</affiliation>
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<author><name sortKey="Shah, Nirav N" sort="Shah, Nirav N" uniqKey="Shah N" first="Nirav N" last="Shah">Nirav N. Shah</name>
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<wicri:regionArea>Division of Hematology & Oncology, Medical College of Wisconsin, Brookfield, WI</wicri:regionArea>
<placeName><region type="state">Wisconsin</region>
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<author><name sortKey="Goy, Andre" sort="Goy, Andre" uniqKey="Goy A" first="Andre" last="Goy">Andre Goy</name>
<affiliation wicri:level="2"><nlm:affiliation>John Theurer Cancer Center, Hackensack Meridian Health, NJ, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center, Hackensack Meridian Health, NJ</wicri:regionArea>
<placeName><region type="state">New Jersey</region>
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<author><name sortKey="Winter, Allison M" sort="Winter, Allison M" uniqKey="Winter A" first="Allison M" last="Winter">Allison M. Winter</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Taussig Cancer Institute, Cleveland Clinic Foundation, OH</wicri:regionArea>
<placeName><region type="state">Ohio</region>
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<author><name sortKey="Garcia, Christine" sort="Garcia, Christine" uniqKey="Garcia C" first="Christine" last="Garcia">Christine Garcia</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Pittsburgh Medical Center, PA</wicri:regionArea>
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<author><name sortKey="Kennard, Kaitlin" sort="Kennard, Kaitlin" uniqKey="Kennard K" first="Kaitlin" last="Kennard">Kaitlin Kennard</name>
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<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
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<author><name sortKey="Isaac, Krista" sort="Isaac, Krista" uniqKey="Isaac K" first="Krista" last="Isaac">Krista Isaac</name>
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<wicri:regionArea>Internal Medicine, Lankenau Medical Center, Wynnewood, PA</wicri:regionArea>
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<author><name sortKey="Dorsey, Colleen" sort="Dorsey, Colleen" uniqKey="Dorsey C" first="Colleen" last="Dorsey">Colleen Dorsey</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Gashonia, Lisa M" sort="Gashonia, Lisa M" uniqKey="Gashonia L" first="Lisa M" last="Gashonia">Lisa M. Gashonia</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Singavi, Arun K" sort="Singavi, Arun K" uniqKey="Singavi A" first="Arun K" last="Singavi">Arun K. Singavi</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Hematology & Oncology, Medical College of Wisconsin, Brookfield, WI, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Hematology & Oncology, Medical College of Wisconsin, Brookfield, WI</wicri:regionArea>
<placeName><region type="state">Wisconsin</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Roeker, Lindsey E" sort="Roeker, Lindsey E" uniqKey="Roeker L" first="Lindsey E" last="Roeker">Lindsey E. Roeker</name>
<affiliation wicri:level="2"><nlm:affiliation>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zelenetz, Andrew" sort="Zelenetz, Andrew" uniqKey="Zelenetz A" first="Andrew" last="Zelenetz">Andrew Zelenetz</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Williams, Annalynn" sort="Williams, Annalynn" uniqKey="Williams A" first="Annalynn" last="Williams">Annalynn Williams</name>
<affiliation wicri:level="2"><nlm:affiliation>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Wilmot Cancer Institute Division of Hematology/Oncology, University of Rochester Medical Center, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Howlett, Christina" sort="Howlett, Christina" uniqKey="Howlett C" first="Christina" last="Howlett">Christina Howlett</name>
<affiliation wicri:level="2"><nlm:affiliation>John Theurer Cancer Center, Hackensack Meridian Health, NJ, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center, Hackensack Meridian Health, NJ</wicri:regionArea>
<placeName><region type="state">New Jersey</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Weissbrot, Hanna" sort="Weissbrot, Hanna" uniqKey="Weissbrot H" first="Hanna" last="Weissbrot">Hanna Weissbrot</name>
<affiliation wicri:level="2"><nlm:affiliation>Columbia University Medical Center, New York, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Columbia University Medical Center, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ali, Naveed" sort="Ali, Naveed" uniqKey="Ali N" first="Naveed" last="Ali">Naveed Ali</name>
<affiliation wicri:level="2"><nlm:affiliation>Abington Hem. Onc. Assoc., Inc., Willow Grove, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Abington Hem. Onc. Assoc., Inc., Willow Grove, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
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<author><name sortKey="Khajavian, Sirin" sort="Khajavian, Sirin" uniqKey="Khajavian S" first="Sirin" last="Khajavian">Sirin Khajavian</name>
<affiliation wicri:level="2"><nlm:affiliation>University of Washington/Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, WA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Washington/Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, WA</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
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<author><name sortKey="Sitlinger, Andrea" sort="Sitlinger, Andrea" uniqKey="Sitlinger A" first="Andrea" last="Sitlinger">Andrea Sitlinger</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
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<author><name sortKey="Tranchito, Eve" sort="Tranchito, Eve" uniqKey="Tranchito E" first="Eve" last="Tranchito">Eve Tranchito</name>
<affiliation wicri:level="2"><nlm:affiliation>Taussig Cancer Institute, Cleveland Clinic Foundation, OH, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Taussig Cancer Institute, Cleveland Clinic Foundation, OH</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
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<author><name sortKey="Rhodes, Joanna" sort="Rhodes, Joanna" uniqKey="Rhodes J" first="Joanna" last="Rhodes">Joanna Rhodes</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
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<author><name sortKey="Felsenfeld, Joshua" sort="Felsenfeld, Joshua" uniqKey="Felsenfeld J" first="Joshua" last="Felsenfeld">Joshua Felsenfeld</name>
<affiliation wicri:level="2"><nlm:affiliation>New York Presbyterian & Weill Cornell, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New York Presbyterian & Weill Cornell, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bailey, Neil" sort="Bailey, Neil" uniqKey="Bailey N" first="Neil" last="Bailey">Neil Bailey</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Patel, Bhavisha" sort="Patel, Bhavisha" uniqKey="Patel B" first="Bhavisha" last="Patel">Bhavisha Patel</name>
<affiliation wicri:level="2"><nlm:affiliation>Washington Hospital Center, DC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Washington Hospital Center, DC</wicri:regionArea>
<placeName><region type="state">District de Columbia</region>
</placeName>
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<author><name sortKey="Burns, Timothy F" sort="Burns, Timothy F" uniqKey="Burns T" first="Timothy F" last="Burns">Timothy F. Burns</name>
<affiliation wicri:level="2"><nlm:affiliation>Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Dartmouth-Hitchcock Medical Center, Lebanon, NH</wicri:regionArea>
<placeName><region type="state">New Hampshire</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Yacur, Melissa" sort="Yacur, Melissa" uniqKey="Yacur M" first="Melissa" last="Yacur">Melissa Yacur</name>
<affiliation wicri:level="2"><nlm:affiliation>Penn State Health, Hershey, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Penn State Health, Hershey, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Malhotra, Mansi" sort="Malhotra, Mansi" uniqKey="Malhotra M" first="Mansi" last="Malhotra">Mansi Malhotra</name>
<affiliation wicri:level="2"><nlm:affiliation>Tufts Medical Center, Boston, MA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Tufts Medical Center, Boston, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Svoboda, Jakub" sort="Svoboda, Jakub" uniqKey="Svoboda J" first="Jakub" last="Svoboda">Jakub Svoboda</name>
<affiliation wicri:level="2"><nlm:affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA</wicri:regionArea>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Furman, Richard R" sort="Furman, Richard R" uniqKey="Furman R" first="Richard R" last="Furman">Richard R. Furman</name>
<affiliation wicri:level="2"><nlm:affiliation>New York Presbyterian & Weill Cornell, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New York Presbyterian & Weill Cornell, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Nabhan, Chadi" sort="Nabhan, Chadi" uniqKey="Nabhan C" first="Chadi" last="Nabhan">Chadi Nabhan</name>
<affiliation wicri:level="2"><nlm:affiliation>Cardinal Health, Dublin, OH, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cardinal Health, Dublin, OH</wicri:regionArea>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
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<series><title level="j">Haematologica</title>
<idno type="eISSN">1592-8721</idno>
<imprint><date when="2018" type="published">2018</date>
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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Antineoplastic Agents (administration & dosage)</term>
<term>Antineoplastic Agents (adverse effects)</term>
<term>Antineoplastic Agents (therapeutic use)</term>
<term>Antineoplastic Combined Chemotherapy Protocols (adverse effects)</term>
<term>Antineoplastic Combined Chemotherapy Protocols (therapeutic use)</term>
<term>Bridged Bicyclo Compounds, Heterocyclic (administration & dosage)</term>
<term>Bridged Bicyclo Compounds, Heterocyclic (adverse effects)</term>
<term>Bridged Bicyclo Compounds, Heterocyclic (therapeutic use)</term>
<term>Disease Management (MeSH)</term>
<term>Drug Resistance, Neoplasm (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Leukemia, Lymphocytic, Chronic, B-Cell (diagnosis)</term>
<term>Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy)</term>
<term>Leukemia, Lymphocytic, Chronic, B-Cell (genetics)</term>
<term>Leukemia, Lymphocytic, Chronic, B-Cell (mortality)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Recurrence (MeSH)</term>
<term>Sulfonamides (administration & dosage)</term>
<term>Sulfonamides (adverse effects)</term>
<term>Sulfonamides (therapeutic use)</term>
<term>Survival Analysis (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Tumor Lysis Syndrome (etiology)</term>
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<term>Adulte d'âge moyen (MeSH)</term>
<term>Analyse de survie (MeSH)</term>
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<term>Antinéoplasiques (effets indésirables)</term>
<term>Antinéoplasiques (usage thérapeutique)</term>
<term>Composés hétérocycliques bicycliques (administration et posologie)</term>
<term>Composés hétérocycliques bicycliques (effets indésirables)</term>
<term>Composés hétérocycliques bicycliques (usage thérapeutique)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Leucémie chronique lymphocytaire à cellules B (diagnostic)</term>
<term>Leucémie chronique lymphocytaire à cellules B (génétique)</term>
<term>Leucémie chronique lymphocytaire à cellules B (mortalité)</term>
<term>Leucémie chronique lymphocytaire à cellules B (traitement médicamenteux)</term>
<term>Mâle (MeSH)</term>
<term>Prise en charge de la maladie (MeSH)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (effets indésirables)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique)</term>
<term>Récidive (MeSH)</term>
<term>Résistance aux médicaments antinéoplasiques (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Sulfonamides (administration et posologie)</term>
<term>Sulfonamides (effets indésirables)</term>
<term>Sulfonamides (usage thérapeutique)</term>
<term>Syndrome de lyse tumorale (étiologie)</term>
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<term>Bridged Bicyclo Compounds, Heterocyclic</term>
<term>Sulfonamides</term>
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<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antineoplastic Agents</term>
<term>Bridged Bicyclo Compounds, Heterocyclic</term>
<term>Sulfonamides</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Agents</term>
<term>Bridged Bicyclo Compounds, Heterocyclic</term>
<term>Sulfonamides</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antinéoplasiques</term>
<term>Composés hétérocycliques bicycliques</term>
<term>Sulfonamides</term>
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<term>Protocoles de polychimiothérapie antinéoplasique</term>
<term>Sulfonamides</term>
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</keywords>
<keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Leucémie chronique lymphocytaire à cellules B</term>
</keywords>
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<term>Composés hétérocycliques bicycliques</term>
<term>Protocoles de polychimiothérapie antinéoplasique</term>
<term>Sulfonamides</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Syndrome de lyse tumorale</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Disease Management</term>
<term>Drug Resistance, Neoplasm</term>
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<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Recurrence</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
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<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Prise en charge de la maladie</term>
<term>Récidive</term>
<term>Résistance aux médicaments antinéoplasiques</term>
<term>Résultat thérapeutique</term>
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<front><div type="abstract" xml:lang="en">Venetoclax is a BCL2 inhibitor approved for 17p-deleted relapsed/refractory chronic lymphocytic leukemia with activity following kinase inhibitors. We conducted a multicenter retrospective cohort analysis of patients with chronic lymphocytic leukemia treated with venetoclax to describe outcomes, toxicities, and treatment selection following venetoclax discontinuation. A total of 141 chronic lymphocytic leukemia patients were included (98% relapsed/refractory). Median age at venetoclax initiation was 67 years (range 37-91), median prior therapies was 3 (0-11), 81% unmutated <i>IGHV</i>
, 45% del(17p), and 26.8% complex karyotype (≥ 3 abnormalities). Prior to venetoclax initiation, 89% received a B-cell receptor antagonist. For tumor lysis syndrome prophylaxis, 93% received allopurinol, 92% normal saline, and 45% rasburicase. Dose escalation to the maximum recommended dose of 400 mg daily was achieved in 85% of patients. Adverse events of interest included neutropenia in 47.4%, thrombocytopenia in 36%, tumor lysis syndrome in 13.4%, neutropenic fever in 11.6%, and diarrhea in 7.3%. The overall response rate to venetoclax was 72% (19.4% complete remission). With a median follow up of 7 months, median progression free survival and overall survival for the entire cohort have not been reached. To date, 41 venetoclax treated patients have discontinued therapy and 24 have received a subsequent therapy, most commonly ibrutinib. In the largest clinical experience of venetoclax-treated chronic lymphocytic leukemia patients, the majority successfully completed and maintained a maximum recommended dose. Response rates and duration of response appear comparable to clinical trial data. Venetoclax was active in patients with mutations known to confer ibrutinib resistance. Optimal sequencing of newer chronic lymphocytic leukemia therapies requires further study.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29880613</PMID>
<DateCompleted><Year>2019</Year>
<Month>09</Month>
<Day>11</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>08</Month>
<Day>27</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1592-8721</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>103</Volume>
<Issue>9</Issue>
<PubDate><Year>2018</Year>
<Month>09</Month>
</PubDate>
</JournalIssue>
<Title>Haematologica</Title>
<ISOAbbreviation>Haematologica</ISOAbbreviation>
</Journal>
<ArticleTitle>Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States.</ArticleTitle>
<Pagination><MedlinePgn>1511-1517</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.3324/haematol.2018.193615</ELocationID>
<Abstract><AbstractText>Venetoclax is a BCL2 inhibitor approved for 17p-deleted relapsed/refractory chronic lymphocytic leukemia with activity following kinase inhibitors. We conducted a multicenter retrospective cohort analysis of patients with chronic lymphocytic leukemia treated with venetoclax to describe outcomes, toxicities, and treatment selection following venetoclax discontinuation. A total of 141 chronic lymphocytic leukemia patients were included (98% relapsed/refractory). Median age at venetoclax initiation was 67 years (range 37-91), median prior therapies was 3 (0-11), 81% unmutated <i>IGHV</i>
, 45% del(17p), and 26.8% complex karyotype (≥ 3 abnormalities). Prior to venetoclax initiation, 89% received a B-cell receptor antagonist. For tumor lysis syndrome prophylaxis, 93% received allopurinol, 92% normal saline, and 45% rasburicase. Dose escalation to the maximum recommended dose of 400 mg daily was achieved in 85% of patients. Adverse events of interest included neutropenia in 47.4%, thrombocytopenia in 36%, tumor lysis syndrome in 13.4%, neutropenic fever in 11.6%, and diarrhea in 7.3%. The overall response rate to venetoclax was 72% (19.4% complete remission). With a median follow up of 7 months, median progression free survival and overall survival for the entire cohort have not been reached. To date, 41 venetoclax treated patients have discontinued therapy and 24 have received a subsequent therapy, most commonly ibrutinib. In the largest clinical experience of venetoclax-treated chronic lymphocytic leukemia patients, the majority successfully completed and maintained a maximum recommended dose. Response rates and duration of response appear comparable to clinical trial data. Venetoclax was active in patients with mutations known to confer ibrutinib resistance. Optimal sequencing of newer chronic lymphocytic leukemia therapies requires further study.</AbstractText>
<CopyrightInformation>Copyright© 2018 Ferrata Storti Foundation.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mato</LastName>
<ForeName>Anthony R</ForeName>
<Initials>AR</Initials>
<AffiliationInfo><Affiliation>CLL Program, Leukemia Service, Division of Hematologic Oncology, Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA matoa@mskcc.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Thompson</LastName>
<ForeName>Meghan</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Center for CLL, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Allan</LastName>
<ForeName>John N</ForeName>
<Initials>JN</Initials>
<AffiliationInfo><Affiliation>New York Presbyterian & Weill Cornell, NY, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Brander</LastName>
<ForeName>Danielle M</ForeName>
<Initials>DM</Initials>
<AffiliationInfo><Affiliation>Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pagel</LastName>
<ForeName>John M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ujjani</LastName>
<ForeName>Chaitra S</ForeName>
<Initials>CS</Initials>
<AffiliationInfo><Affiliation>Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hill</LastName>
<ForeName>Brian T</ForeName>
<Initials>BT</Initials>
<AffiliationInfo><Affiliation>Taussig Cancer Institute, Cleveland Clinic Foundation, OH, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lamanna</LastName>
<ForeName>Nicole</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Columbia University Medical Center, New York, NY, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lansigan</LastName>
<ForeName>Frederick</ForeName>
<Initials>F</Initials>
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<name sortKey="Sitlinger, Andrea" sort="Sitlinger, Andrea" uniqKey="Sitlinger A" first="Andrea" last="Sitlinger">Andrea Sitlinger</name>
<name sortKey="Skarbnik, Alan P" sort="Skarbnik, Alan P" uniqKey="Skarbnik A" first="Alan P" last="Skarbnik">Alan P. Skarbnik</name>
<name sortKey="Svoboda, Jakub" sort="Svoboda, Jakub" uniqKey="Svoboda J" first="Jakub" last="Svoboda">Jakub Svoboda</name>
<name sortKey="Tranchito, Eve" sort="Tranchito, Eve" uniqKey="Tranchito E" first="Eve" last="Tranchito">Eve Tranchito</name>
<name sortKey="Tuncer, Hande H" sort="Tuncer, Hande H" uniqKey="Tuncer H" first="Hande H" last="Tuncer">Hande H. Tuncer</name>
<name sortKey="Ujjani, Chaitra S" sort="Ujjani, Chaitra S" uniqKey="Ujjani C" first="Chaitra S" last="Ujjani">Chaitra S. Ujjani</name>
<name sortKey="Weissbrot, Hanna" sort="Weissbrot, Hanna" uniqKey="Weissbrot H" first="Hanna" last="Weissbrot">Hanna Weissbrot</name>
<name sortKey="Williams, Annalynn" sort="Williams, Annalynn" uniqKey="Williams A" first="Annalynn" last="Williams">Annalynn Williams</name>
<name sortKey="Winter, Allison M" sort="Winter, Allison M" uniqKey="Winter A" first="Allison M" last="Winter">Allison M. Winter</name>
<name sortKey="Yacur, Melissa" sort="Yacur, Melissa" uniqKey="Yacur M" first="Melissa" last="Yacur">Melissa Yacur</name>
<name sortKey="Zelenetz, Andrew" sort="Zelenetz, Andrew" uniqKey="Zelenetz A" first="Andrew" last="Zelenetz">Andrew Zelenetz</name>
<name sortKey="Zent, Clive S" sort="Zent, Clive S" uniqKey="Zent C" first="Clive S" last="Zent">Clive S. Zent</name>
</country>
</tree>
</affiliations>
</record>
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