A review of the incidence of tumor lysis syndrome in patients with chronic lymphocytic leukemia treated with venetoclax and debulking strategies
Jeffrey P. Sharman,
Juliana M. L. Biondo,
Michelle Boyer,
Kirsten Fischer,
Michael Hallek,
Dingfeng Jiang,
Arnon P. Kater,
Michele Porro Lurà,
William G. Wierda
Affiliations
Jeffrey P. Sharman
Department of Medical Oncology Willamette Valley Cancer Institute and Research Center/US Oncology Research Eugene Oregon USA
Juliana M. L. Biondo
Genentech, Inc. South San Francisco California USA
Michelle Boyer
Roche Products Limited Welwyn Garden City UK
Kirsten Fischer
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf Germany
Michael Hallek
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf Germany
Dingfeng Jiang
AbbVie North Chicago Illinois USA
Arnon P. Kater
Department of Hematology Cancer Center Amsterdam Lymphoma and Myeloma Center Amsterdam Amsterdam University Medical Centers Amsterdam the Netherlands
Michele Porro Lurà
F. Hoffmann‐La Roche Ltd Basel Switzerland
William G. Wierda
Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
Abstract We reviewed the literature (January 2010–June 2021) on the effectiveness of debulking strategies before venetoclax initiation in patients with chronic lymphocytic leukemia to reduce tumor burden, downgrade tumor lysis syndrome (TLS) risk, and avoid hospitalization. Low TLS incidence and reduced TLS risk based on tumor burden were reported following debulking in clinical trials. Real‐world observational studies reporting debulking regimens recorded no TLS events, and those without debulking strategies had greater TLS incidence. Debulking prior to venetoclax considerably reduces TLS incidence. Further clinical trials and real‐world studies may provide additional evidence on effectiveness of debulking in reducing TLS incidence and hospitalization need.
