Written By: Jon Suyko, PharmD, BCPS UCHealth Highlands Ranch
Description Venetoclax is as selective inhibitor of B cell lymphoma-2 (BCL-2). Inhibition of BCL-2 by venetoclax results in cytotoxic activity in tumor cells that overexpress BCL-2 by restoring apoptosis. Venetoclax is indicated in Acute myeloid leukemia (AML), chronic lymphoid leukemia (CLL) and small lymphocytic leukemia (SLL) in patients with or without chromosome 17p deletion. During the ramp-up phase, patients are titrated on venetoclax and assigned a risk category based on tumor burden and potential for developing Tumor Lysis Syndrome (TLS). These risk stratifications create special challenges for the dispensing of venetoclax. Some medium-risk and all high-risk patients may require hospital admission during titration; communication between the oncology pharmacist, nurse, lab technicians, hematologist, and the patient will ensure the recommended administration guidelines and lab monitoring are followed to ensure patient safety and best outcomes.