open access

Vol 12, No 2 (2021)
Guidelines / Expert consensus
Published online: 2021-10-07
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Polish Experts’ Position Statement on the use of granulocyte colony-stimulating factor in the treatment of chronic lymphocytic leukemia with venetoclax combined with rituximab

Elżbieta Iskierka-Jażdżewska1, Krzysztof Giannopoulos2, Sebastian Grosicki3, Krzysztof Jamroziak4, Tomasz Wróbel5, Jan Maciej Zaucha6, Marek Dudziński7, Łukasz Bołkuń8, Ewa Bodzenta9, Joanna Drozd-Sokołowska10, Agnieszka Samborska11, Anna Wolska-Washer12, Iwona Hus13
DOI: 10.5603/HCP.2021.0008
·
Hematology in Clinical Practice 2021;12(2):67-71.
Affiliations
  1. Department of Haematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
  2. Department of Experimental Haemato-Oncology, Medical University of Lublin, Poland
  3. Department of Haematology and Cancer Prevention, Chorzów School of Public Health, Medical University of Silesia, Katowice, Poland
  4. Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
  5. Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
  6. Department of Haematology and Transplantology, Medical University of Gdansk, Poland
  7. Hematology Department, Teaching Hospital No. 1, Rzeszow, Poland
  8. Department of Haematology, Medical University of Bialystok, Bialystok, Poland
  9. Department of Haematology and Cancer Prevention, Chorzów School of Public Health, Medical University of Silesia, Katowice, Poland
  10. Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
  11. AbbVie, Warszawa, Poland
  12. Department of Haematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
  13. Department of Haematology, Institute of Haematology and Transfusion Medicine, Warsaw, Poland

open access

Vol 12, No 2 (2021)
EXPERTS' POSITION
Published online: 2021-10-07

Abstract

Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia in Western countries. Venetoclax, a BCL-2 inhibitor, in combination with rituximab is an effective therapeutic option approved for the treatment of refractory and relapsed CLL. Neutropenia diagnosed before or during the above-mentioned therapy is a significant clinical problem, which often involves the need to reduce the dose or temporarily discontinue venetoclax in the initial period of therapy. In Experts’ opinion, the use of granulocyte colony-stimulating factor (G-CSF) during venetoclaxrituximab combined therapy is reasonable in patients with baseline neutrocyte count < 1000–500/mm3 and with high-risk neutropenia. The second important group for the use of G-CSF are patients developing grade 3 asymptomatic neutropenia during venetoclax dose escalation. Using G-CSF can prevent episodes that affect the maintenance of the venetoclax dose intensity and treatment continuity.

Abstract

Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia in Western countries. Venetoclax, a BCL-2 inhibitor, in combination with rituximab is an effective therapeutic option approved for the treatment of refractory and relapsed CLL. Neutropenia diagnosed before or during the above-mentioned therapy is a significant clinical problem, which often involves the need to reduce the dose or temporarily discontinue venetoclax in the initial period of therapy. In Experts’ opinion, the use of granulocyte colony-stimulating factor (G-CSF) during venetoclaxrituximab combined therapy is reasonable in patients with baseline neutrocyte count < 1000–500/mm3 and with high-risk neutropenia. The second important group for the use of G-CSF are patients developing grade 3 asymptomatic neutropenia during venetoclax dose escalation. Using G-CSF can prevent episodes that affect the maintenance of the venetoclax dose intensity and treatment continuity.

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Keywords

chronic lymphocytic leukaemia, granulocyte colony-stimulating factor, neutropenia, rituximab, venetoclax

About this article
Title

Polish Experts’ Position Statement on the use of granulocyte colony-stimulating factor in the treatment of chronic lymphocytic leukemia with venetoclax combined with rituximab

Journal

Hematology in Clinical Practice

Issue

Vol 12, No 2 (2021)

Article type

Guidelines / Expert consensus

Pages

67-71

Published online

2021-10-07

DOI

10.5603/HCP.2021.0008

Bibliographic record

Hematology in Clinical Practice 2021;12(2):67-71.

Keywords

chronic lymphocytic leukaemia
granulocyte colony-stimulating factor
neutropenia
rituximab
venetoclax

Authors

Elżbieta Iskierka-Jażdżewska
Krzysztof Giannopoulos
Sebastian Grosicki
Krzysztof Jamroziak
Tomasz Wróbel
Jan Maciej Zaucha
Marek Dudziński
Łukasz Bołkuń
Ewa Bodzenta
Joanna Drozd-Sokołowska
Agnieszka Samborska
Anna Wolska-Washer
Iwona Hus

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