Venetoclax: Management and Care for Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia

Heather Brumbaugh Paradis, RN, MSN, ANP-BC, AOCN®; Debbie Alter, RN, BSN; Diane Llerandi, MA, RN, AOCNS®
CJON
10.1188/17.CJON.604-610

Description

Background: Venetoclax (Venclexta™) is a potent, selective, orally available, small-molecule B-cell lymphoma 2 inhibitor that achieves response rates of about 80% and has an acceptable safety profile for patients with relapsed or refractory chronic lymphocytic leukemia (CLL).


Objectives: The aim was to describe treatment management considerations when caring for patients using venetoclax.


Methods: A review was done of safety and management considerations based on current clinical practice and 240 patients with CLL who received venetoclax monotherapy on clinical trials from 2011–2016.


Findings: Common adverse events were neutropenia, diarrhea, nausea, anemia, upper respiratory tract infection, thrombocytopenia, and fatigue. Because of rapid tumor reduction with venetoclax, nurses should be aware of the potential for tumor lysis syndrome (TLS) and the need to educate patients on steps to minimize risks, including gradual dose ramp-up, adequate hydration, and use of prophylactic antihyperuricemia agents. Following implementation of these risk-reducing measures, no clinical TLS events were reported in ongoing trials.

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