NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

31 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 3 Cancer treatments Targeted therapy Serious but uncommon side effects include liver and lung problems, skin problems, severe diarrhea, and holes in your gut. Venetoclax Venetoclax is a small molecule inhibitor that targets the BCL-2 protein. This type of targeted therapy stops a function within the cell that helps it survive. Venetoclax is used alone or sometimes with rituximab to treat CLL. It is recommended for CLL that responds to treatment but comes back (relapsed), or the first treatment doesn’t work (refractory). It is made in pill form and is taken once a day. Common side effects of venetoclax are low blood cells counts, diarrhea, nausea, upper respiratory tract infection, and tiredness. Venetoclax also increases your chances for tumor lysis syndrome. Ask your treatment team for a full list of side effects. Obinutuzumab Obinutuzumab attaches to a molecule on CLL cells called CD20. See Figure 9. It works by marking cells for destruction but it may directly kill the cells, too. It is used alone and sometimes with chemotherapy to treat CLL. Obinutuzumab is a liquid that will be slowly injected into your vein. It takes a few hours to get the full dose. Obinutuzumab is given on some days during six 28-day treatment cycles. You may have an allergic reaction while receiving obinutuzumab. Tumor lysis syndrome, infections, and hepatitis are more likely while taking obinutuzumab. Although not common, you may become confused, dizzy, and have difficulty walking, talking, or seeing. Ofatumumab Ofatumumab is another monoclonal antibody that attaches to CD20. However, it attaches to a different part of CD20. It is used alone and sometimes with chemotherapy to treat CLL. Ofatumumab is a liquid that will be slowly injected into your vein. It takes about 6 hours to receive the first dose. Other doses may be given in less time. Ofatumumab is often given once a week for 8 weeks. Then it’s restarted after a 4- or 5-week break. After the break, ofatumumab is often received once a month for four months. You may have an allergic reaction while receiving ofatumumab. Other common side effects include low blood cell counts, infections, diarrhea, nausea, fatigue, and rash. Hepatitis B can be reactivated while taking ofatumumab. Figure 9 Anti-CD20 monoclonal antibody Anti-CD20 monoclonal antibodies attach to CLL cells to mark them for destruction by your immune system. Derivative work of Rituximab Binding to CD20 on a B Cell Surface by NIAID available at commons.wikimedia.org/wiki/File: Rituxima_Binding_to_CD20_ on_a_B_Cell_Surface_(6830897205).jpg under a Creative Commons Attribution 2.0 Generic license

RkJQdWJsaXNoZXIy MTE3MTE1