Established protocol for prophylaxis and management of TLS1,2

  • The risk of TLS is a continuum based on multiple factors, including tumor burden and other comorbidities. Reduced renal function (CrCl <80 mL/min) further increases the risk
  • Changes in electrolytes consistent with TLS that require prompt management can occur as early as 6 to 8 hours following the first dose and each dose increase

*Start allopurinol or xanthine oxidase inhibitor 2–3 days prior to initiation of VENCLYXTO.

1.5–2 L of water (6–8 glasses) should be consumed every day starting 2 days before the first dose and throughout the dose-titration phase, especially the first day of each dose increase. Administer intravenous hydration for any patient who cannot tolerate oral hydration.

Blood chemistry monitoring: potassium, uric acid, phosphorus, calcium, and creatinine (review in real time).

§For patients at risk of TLS, monitor blood chemistries at 6–8 hours and at 24 hours at each subsequent titration dose.

  • No patient is typical. Please refer to the full VENCLYXTO SmPC when making treatment decisions

CLL=chronic lymphocytic leukemia; 1L=first line; 2L+=second line + later lines of therapy; O+Clb=obinutuzumab + chlorambucil; HR=hazard ratio; CI=confidence interval; PFS=progression-free survival; BR=bendamustine + rituximab; VEN+R=VENCLYXTO + rituximab; TLS=tumor lysis syndrome; CrCl=creatinine clearance; LN=lymph node; ALC=absolute lymphocyte count; IV=intravenous.

[Placeholder for safety balance required by local regulations]

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References: 1. VENCLYXTO Summary of Product Characteristics. Ludwigshafen, Germany: AbbVie Deutschland GmbH & Co. KG. <Current SmPC.>  2. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. V4.2020. National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed February 6, 2020. To view the most recent and complete version of the guideline, go online to NCCN.org.

GR-VNCCLL-200048 -JAN2021