• The risk of TLS is a continuum based on multiple factors, including tumor burden and comorbidities. Reduced renal function (CLcr <80 mL/min) further increases the risk
  • Changes in blood chemistries consistent with TLS that require prompt management can occur as early as 6 to 8 hours following the first dose and each dose increase

*Start allopurinol or xanthine oxidase inhibitor 2-3 days prior to initiation of VENCLEXTA (venetoclax tablets).
1.5-2 L of water (6-8 glasses) should be consumed every day starting 2 days before the first dose and throughout the ramp-up phase, especially the first day of each dose increase. Administer intravenous hydration for any patient who cannot tolerate oral hydration.
Review in real time.
§For patients at risk of TLS, monitor blood chemistries at 6-8 hours and at 24 hours at each subsequent ramp-up dose.

TLS=tumor lysis syndrome; CLcr=creatinine clearance; ALC=absolute lymphocyte count; LN=lymph node.

Blood chemistry monitoring: potassium, calcium, creatinine, phosphorus, uric acid (review in real time).