Chronic Lymphocytic Leukemia | Visiting The Investigators: Prevention and Management of Tumor Lysis Syndrome, Neutropenia and Other Toxicities Associated with Novel Therapies for Chronic Lymphocytic Leukemia

published 1 month ago by Dr Neil Love

Featuring a roundtable discussion with Ms Amy Goodrich and Drs Gigi Chen, Ilya Glezerman, Dipti Gupta, Yanjun Ma and Anthony R Mato, including the following topics: Case: A man in his mid-50s with treatment-naïve chronic lymphocytic leukemia (CLL) with no IGHV mutation begins therapy with venetoclax/obinutuzumab and develops tumor lysis syndrome (TLS) after cycle 1 of obinutuzumab — Anthony R Mato, MD, MSCE (0:00) Assessing patients with CLL for risk of TLS; use of antihyperuricemic agents (rasburicase and allopurinol) in the management of TLS associated with venetoclax/obinutuzumab (7:21) Selection of first-line therapy for patients with CLL (16:33) Perspective on the choice of Bruton tyrosine kinase (BTK) inhibitors versus venetoclax/obinutuzumab as up-front therapy (21:10) Results of the Phase III ELEVATE-RR study evaluating acalabrutinib versus ibrutinib for patients with previously treated, high-risk CLL; key findings from the ALPINE study comparing zanubrutinib to ibrutinib for relapsed CLL (24:01) GLOW: A Phase III trial of ibrutinib and venetoclax for untreated CLL/small lymphocytic lymphoma; efficacy and tolerability of LOXO-305 (pirtobrutinib) for CLL (29:44) Case: A man in his mid-40s with treatment-naïve CLL with an IGHV mutation receives venetoclax/obinutuzumab and develops neutropenia — Dr Mato (34:08) Treatment of neutropenia associated with venetoclax/obinutuzumab (38:11) Monitoring and management of renal dysfunction related to venetoclax-based regimens (44:23) Case: A man in his mid-60s with relapsed/refractory CLL who experiences disease progression on ibrutinib starts therapy with venetoclax/rituximab and develops biochemical TLS — Dr Mato (48:44) Pathophysiology of TLS; laboratory and clinical criteria for identifying patients at risk (51:30) Recommendations for mitigating the risk associated with TLS; real-world data on risk and prophylaxis (1:00:42) Efficacy and tolerability of febuxostat, allopurinol or rasburicase for the prevention and management of TLS (1:05:13) Case: A woman in her late 80s with relapsed/refractory CLL and underlying renal disease receives venetoclax monotherapy — Dr Mato (1:10:07) Case: A man in his early 60s with CLL develops atrial fibrillation after first-line therapy with ibrutinib — Dr Mato (1:23:30) Management of atrial fibrillation associated with ibrutinib (1:25:13) Evaluation of patients with atrial fibrillation; perspective on switching BTK inhibitors for those who develop cardiac adverse events (1:33:29) Cardiac side effects of BTK inhibitors; hypertension and ventricular arrythmias associated with ibrutinib (1:37:57) Incidence, risk factors and treatment of atrial fibrillation and bleeding related to ibrutinib (1:44:28) CME information and select publications

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