The risk of TLS in patients with relapsed CLL treated outside of clinical trials is not well described. Using the Mayo Clinic CLL Database, 48 patients treated with venetoclax for relapsed CLL in routine practice were identified; chart review determined baseline risk for TLS and laboratory abnormalities during venetoclax ramp-up. Overall, 6 (13%) patients developed laboratory TLS, 3 of whom demonstrated clinical TLS. The majority of patients who developed TLS were stratified as low or medium risk by the package insert. Of the 42 patients who did not meet Howard criteria for TLS, isolated hyperphosphatemia occurred in 19 patients (45%), hyperkalemia in 13 patients (31%), hyperuricemia in 2 patients (5%), and hypocalcemia in 1 patient (2%). In routine practice, the incidence of TLS appears higher than reported in clinical trials (3–6%). Half of patients who did not meet criteria for TLS developed clinically significant electrolyte abnormalities that required medical intervention.

在临床试验之外接受治疗的CLL复发患者中TLS的风险并未得到很好的描述。使用Mayo Clinic CLL数据库，确定了48例常规行venetoclax治疗的复发性CLL患者。图表审查确定了Venetoclax加速期间TLS和实验室异常的基线风险。总体而言，有6名（13％）患者发展了实验室TLS，其中3名表现出临床TLS。包装说明书将大多数发生TLS的患者分为中低风险。在不符合霍华德TLS标准的42例患者中，有19例（45％）发生单纯性高磷酸盐血症，13例（31％）发生高钾血症，2例（5％）发生高尿酸血症，1例（2％）发生低钙血症）。在常规实践中，TLS的发生率似乎比临床试验中报道的要高（3–6％）。