Venetoclax 是一种 BCL2 抑制剂，用于治疗可导致肿瘤溶解综合征 (TLS) 的慢性淋巴细胞白血病 (CLL)。我们的目的是确定 2016 年 1 月 1 日至 2020 年 12 月 31 日在我们机构接受维奈托克治疗的 CLL/小淋巴细胞淋巴瘤 (SLL) 患者中 TLS 的发病率和危险因素。我们纳入了 136 名 CLL 患者中的 616 例维奈托克升级。 74 名患者 (54%) 只接受了门诊升级，35 名患者 (26%) 至少计划过一次住院治疗，27 名患者 (20%) 只升级为住院患者。在维奈托克治疗期间，86% 的患者接受别嘌呤醇治疗，71% 的患者接受静脉补液，18% 的患者接受磷酸盐结合剂治疗，10% 的患者接受预防性拉布立酶治疗。在整个队列中，7 名患者（5.1%）按照修改后的 Cairo Bishop 标准发展为实验室 TLS，没有人发展为临床 TLS。对于仅住院患者升级的患者，实验室 TLS 的发生率为 15%；对于接受任何预防性住院治疗的患者，实验室 TLS 的发生率为 2.9%；对于仅升级门诊患者的患者，实验室 TLS 的发生率为 2.7%。那些患有 TLS 的人更有可能有更高的 TLS 风险，并且没有发现其他风险因素。在这项单一机构回顾性队列研究中，观察到了实验室 TLS，但没有观察到临床 TLS。包括使用静脉补液在内的预防措施可能导致门诊中观察到的 TLS 发生率较低。版权所有 © 2024 美国血液学会。

Venetoclax is a BCL2 inhibitor used in chronic lymphocytic leukemia (CLL) which can cause tumor lysis syndrome (TLS). We aimed to determine the incidence of and risk factors for TLS among patients with CLL/small lymphocytic lymphoma (SLL) who received treatment with venetoclax at our institution from 1/1/2016 to 12/31/2020. We included 616 venetoclax escalations among 136 pts with CLL. 74 pts (54%) underwent escalation exclusively outpatient, 35 (26%) had at least one planned hospitalization and 27 (20%) were escalated exclusively inpatient. During venetoclax initiation, 86% of pts received allopurinol, 71% intravenous hydration, 18% phosphate binders, and 10% prophylactic rasburicase. Among the entire cohort, 7 pts (5.1%) developed laboratory TLS by modified Cairo Bishop criteria and none developed clinical TLS. Incidence of laboratory TLS was 15% for those escalated exclusively inpatient, 2.9% for those with any prophylactic hospitalization and 2.7% for those escalated exclusively outpatient. Those who developed TLS were more likely to have higher TLS risk, and no additional risk factors were identified. In this single institution retrospective cohort study, laboratory TLS was observed, though clinical TLS was not. Prophylactic measures, including use of IV hydration, may have contributed to low rates of observed TLS in the outpatient setting.Copyright © 2024 American Society of Hematology.