Bita Fakhri, MD, MPH, a professor of medicine in the Division of Hematology/Oncology at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses concern over the tumor lysis syndrome (TLS) that occurred in the CLL14 trial that looked at patients with previously untreated chronic lymphocytic leukemia (CLL).

With the venetoclax (Venclexta)/obinutuzumab (Gazyva) regimen given to patients with CLL, there is fear regarding the onset of TLS, explains Fakhri. However, in 216 patients with previously untreated CLL who participated in the CLL14 trial, only 3 developed TLS and none met the Howard clinical criteria for TLS.

Further, all 3 patients developed TLS in the first 21 days when they were receiving obinutuzumab whereas venetoclax starts on day 22 in this regimen, concludes Fakhri.