ASH Clinical News June 2017 NEW #2 | Page 29

CLINICAL NEWS self-limited gastrointestinal (GI) events (in- cluding diarrhea [n=27; 55%] and nausea [n=25; 51%]) and upper respiratory tract infections (n=28; 55%). Seventy-six percent of patients (n=37) experienced grade 3/4 AEs, the most common of which were peripheral blood cytopenias, including neutropenia (n=26; 53%), thrombocytopenia (n=8; 16%), ane- mia (n=7; 14%), febrile neutropenia (n=6; 12%), and leukopenia (n=6; 12%). The most common serious AEs were pyrexia (n=6; 12%), febrile neutropenia (n=5; 10%), lower respiratory tract infection (n=3; 6%), and pneumonia (n=3; 6%). Five patients experienced tumor lysis syndrome (TLS), which resulted in one death. Following those events, the study protocol was amended to include a lower starting dose of venetoclax (20 mg) and modified TLS prophylaxis. Among the 32 patients in whom venetoclax was resumed, no clinical TLS was observed. Twenty patients (41%) had dose reductions, most commonly because of cytopenias (n=9; 18%) and GI events (n=4; 6%). Three deaths were reported, from metabolism and nutrition disorders (n=1) and neoplasms (n=2). Time to first response was 2.9 months (range = 0.7-15.7 months), and CRs were attained for a median of 9.2 months (range = 6.4-28.6 months). By the end of therapy, 25 patients (51%) achieved CR or CR with incomplete marrow recovery (CRi) as best response. The best respons- es according to venetoclax dose level were as follows: • 200 mg: 33% CR/CRi, 67% nodular PR/PR • 300 mg: 50% CR/CRi, 30% nodular PR/PR, 10% stable disease • 400 mg: 75% CR/CRi, 13% stable disease (not assessed in 1 patient) • 500 mg: 57% CR/CRi, 29% nodular