Management and use of healthcare resources in patients with chronic lymphocytic leukemia initiating venetoclax in routine clinical practice

Leuk Lymphoma. 2024 May;65(5):609-617. doi: 10.1080/10428194.2024.2301738. Epub 2024 Jan 18.

Abstract

Venetoclax is a first-in-class B-cell lymphoma-2 (BCL-2) inhibitor approved as continuous monotherapy and in combination with rituximab as fixed-treatment duration for relapsed and refractory chronic lymphocytic leukemia (R/R CLL). DEVOTE was a 24-week, multicenter observational study (NCT03310190) evaluating the safety, healthcare resource utilization (HCRU) and health-related quality of life (HRQoL) of patients initiating venetoclax for R/R CLL in Canada. Overall, 89 patients received 1 dose of venetoclax; 80% had prior exposure (42% resistant) to ibrutinib. Biochemical tumor lysis syndrome (TLS) occurred in five patients. We observed differences in hospitalization across Canadian provinces including in patients at low risk for TLS with no clear impact on TLS incidence. Additionally, a rapid and sustained improvement in several domains of HRQoL was observed during venetoclax initiation. Early adoption of venetoclax was mainly for R/R CLL patients with few treatment options; nonetheless, acceptable toxicity and a positive impact on HRQoL were observed.

Keywords: Venetoclax; chronic lymphocytic leukemia; real-world evidence; tumor lysis syndrome.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Bridged Bicyclo Compounds, Heterocyclic* / administration & dosage
  • Bridged Bicyclo Compounds, Heterocyclic* / adverse effects
  • Bridged Bicyclo Compounds, Heterocyclic* / therapeutic use
  • Canada / epidemiology
  • Disease Management
  • Female
  • Health Resources / statistics & numerical data
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Male
  • Middle Aged
  • Quality of Life*
  • Sulfonamides* / administration & dosage
  • Sulfonamides* / adverse effects
  • Sulfonamides* / therapeutic use
  • Treatment Outcome
  • Tumor Lysis Syndrome / etiology

Substances

  • venetoclax
  • Sulfonamides
  • Bridged Bicyclo Compounds, Heterocyclic
  • Antineoplastic Agents