Table 2. Recommended Venetoclax Dose Modifications for Toxicities in CLL/SLL.

Event	Occurrence	Action
Tumor lysis syndrome
Blood chemistry changes or symptoms suggestive of TLS	Any	Withhold next day's dose; if resolved within 24–48 hr of last dose, resume at the same dose
		If resolved in 48 hr or more, resume at a reduced dose
		For any clinical TLS events,a resume at a reduced dose following their resolution
Nonhematologic toxicities
Grade 3–4	First occurrence	Interrupt venetoclax; resume at the same dose once the toxicity has resolved to grade 1 or baseline level. No dose modification is required
	≥ Second occurrence	Interrupt venetoclax; when resuming treatment after resolution, use a reduced dose (for a dose at interruption of 400, 300, 200, 100, 50, or 20 mg use 300, 200, 100, 50, 20, or 10 mg, respectively)
Hematologic toxicities
All grade 4 (except lymphopenia)	First occurrence	Interrupt venetoclax; administer G-CSF to reduce infection risks associated with neutropenia, if clinically indicated. Once toxicity has resolved to grade 1 or baseline level, resume venetoclax at the same dose
	≥ Second occurrence	Interrupt venetoclax; consider using G-CSF as clinically indicated; when resuming treatment after resolution, use a reduced dose (for a dose at interruption of 400, 300, 200, 100, 50, or 20 mg use 300, 200, 100, 50, 20, or 10 mg, respectively)

Note. CLL = chronic lymphocytic leukemia; SLL = small lymphocytic lymphoma; G-CSF = granulocyte colony-stimulating factor; TLS = tumor lysis syndrome.

^aClinical TLS was defined as laboratory TLS with clinical consequences such as acute renal failure, cardiac arrhythmias, or sudden death and/or seizures.