Changein ALC with venetoclax and association with TLS at each venetoclax dose
| Venetoclax dose level, mg . | Patients, n . | Patients with TLS, n (%) . | Pre-ALC . | Post-ALC . | Decrease in ALC (pre to post) . | |||
|---|---|---|---|---|---|---|---|---|
| Median (range), ×103/μL . | n . | Median (range), ×103/μL . | n . | Median (range), ×103/μL . | n . | |||
| 20 | 33 | 6 (18) | 30.8 (0.5-307.3) | 33 | 17.8 (0.5-138.6) | 33 | 4.3 (−21.1 to 168.7) | 33 |
| 50 | 33 | 8 (24) | 15.9 (0.5-138.6) | 33 | 10.3 (0.1-103.3) | 32 | 3.7 (−5.3 to 68.4) | 32 |
| 100 | 33 | 8 (24) | 5.8 (0.4-62.2) | 32 | 3.9 (0.3-64.9) | 33 | 1.6 (−4.7 to 45.4) | 32 |
| 200 | 32 | 4 (13) | 3.4 (0.3-36.4) | 29 | 2.5 (0.4-45.3) | 29 | 0.7 (−9 to 13.1) | 29 |
| 400 | 28 | 3 (11) | 1.1 (0.4-45.3) | 20 | 1.1 (0.4-39.9) | 19 | 0.2 (−0.4 to 5.4) | 19 |
| Venetoclax dose level, mg . | Patients, n . | Patients with TLS, n (%) . | Pre-ALC . | Post-ALC . | Decrease in ALC (pre to post) . | |||
|---|---|---|---|---|---|---|---|---|
| Median (range), ×103/μL . | n . | Median (range), ×103/μL . | n . | Median (range), ×103/μL . | n . | |||
| 20 | 33 | 6 (18) | 30.8 (0.5-307.3) | 33 | 17.8 (0.5-138.6) | 33 | 4.3 (−21.1 to 168.7) | 33 |
| 50 | 33 | 8 (24) | 15.9 (0.5-138.6) | 33 | 10.3 (0.1-103.3) | 32 | 3.7 (−5.3 to 68.4) | 32 |
| 100 | 33 | 8 (24) | 5.8 (0.4-62.2) | 32 | 3.9 (0.3-64.9) | 33 | 1.6 (−4.7 to 45.4) | 32 |
| 200 | 32 | 4 (13) | 3.4 (0.3-36.4) | 29 | 2.5 (0.4-45.3) | 29 | 0.7 (−9 to 13.1) | 29 |
| 400 | 28 | 3 (11) | 1.1 (0.4-45.3) | 20 | 1.1 (0.4-39.9) | 19 | 0.2 (−0.4 to 5.4) | 19 |
Odds of developing TLS increased by 32% for each 10-unit drop in ALC (odds ratio, 1.32; 95% confidence interval [CI], 1.04-1.68; P = .02), even after accounting for venetoclax dose level. Many patients were leukopenic by the time they received 200- and 400-mg doses, leading to lower overall risk for TLS and limited ability to calculate ALC in some cases.