Concomitant Venetoclax and Imatinib for Comanaging Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia: A Case Report
Patients with synchronous malignancies can be problematic to diagnose and manage because workup and therapeutic targeting for each individual malignancy must be coordinated carefully. This report presents a patient with concurrent chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) managed with concomitant venetoclax and imatinib. Because imatinib is a moderate cytochrome P450 3A4 inhibitor, close monitoring is required when using with a substrate of 3A4 such as venetoclax. Although the target dose of venetoclax is 400 mg, it was capped at 100 mg due to the interaction. Despite the interaction and possible enhancement of toxicities, the patient has tolerated therapy well, and both diseases have responded to this novel approach. In addition, because aberrant BCL-2 activity has been implicated in CML, the use of venetoclax may contribute to success in the management of this patient’s CML. This case report represents the safe concomitant use of venetoclax and imatinib in a patient with synchronous CML and CLL.
Submitted April 8, 2022; final revision received August 18, 2022; accepted for publication August 18, 2022.
Author contributions: Conceptualization: Przespolewski, Baron, Hernandez-Ilizaliturri. Data curation: Przespolewski, Baron, Kashef, Jani Sait, Thompson. Formal analysis: Kashef, Fu, Jani Sait, Thompson. Investigation: Przespolewski, Fu. Methodology: Przespolewski, Fu. Resources: Hernandez-Ilizaliturri. Supervision: Przespolewski. Writing—original draft: All authors. Writing—review and editing: All authors.
Disclosures: Dr. Hernandex-Ilizaliturri has disclosed serving as a consultant for AbbVie, Amgen, Celgene, Epizyme, Karyopharm, Kura Oncology, MorhpoSys, and Seattle Genetics. Dr. Thompson has disclosed receiving grant/research support from Novartis. The remaining others have disclosed that they have not received any financial considerations from any person or organization to support the preparation, analysis, results, or discussion of this article.
© 2019-2023 National Comprehensive Cancer Network