{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T03:15:56Z","timestamp":1771989356776,"version":"3.50.1"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vanderbilt Medical Scientist Training Program (MSTP)","award":["T32"],"award-info":[{"award-number":["T32"]}]},{"name":"Vanderbilt Medical Scientist Training Program (MSTP)","award":["T32GM007347"],"award-info":[{"award-number":["T32GM007347"]}]},{"name":"NIGMS of the National Institutes of Health","award":["T32"],"award-info":[{"award-number":["T32"]}]},{"name":"NIGMS of the National Institutes of Health","award":["T32GM007347"],"award-info":[{"award-number":["T32GM007347"]}]},{"name":"American Society of Hematology Minority Hematology Fellow Award","award":["T32"],"award-info":[{"award-number":["T32"]}]},{"name":"American Society of Hematology Minority Hematology Fellow Award","award":["T32GM007347"],"award-info":[{"award-number":["T32GM007347"]}]},{"name":"Robert A. Winn CDA Diversity in Clinical Trials Career Development Award","award":["T32"],"award-info":[{"award-number":["T32"]}]},{"name":"Robert A. Winn CDA Diversity in Clinical Trials Career Development Award","award":["T32GM007347"],"award-info":[{"award-number":["T32GM007347"]}]},{"name":"Multiple Myeloma Research Foundation Research Scholars Award","award":["T32"],"award-info":[{"award-number":["T32"]}]},{"name":"Multiple Myeloma Research Foundation Research Scholars Award","award":["T32GM007347"],"award-info":[{"award-number":["T32GM007347"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Tumor lysis syndrome (TLS) is a rare occurrence in patients treated with venetoclax mono- or combination therapy, and clear protocols guiding TLS prophylaxis are lacking. Case Presentation: We present a 53-year-old male with a history of relapsed refractory multiple myeloma (RRMM) with t(11;14) treated with venetoclax, carfilzomib and dexamethasone (VenKd), resulting in TLS with subsequent renal failure. Repeat marrow biopsy showed no monoclonal plasma cells but extensive fibrosis. Venetoclax was reintroduced after two months with marrow recovery. Venetoclax was titrated from 200 to 400 mg daily alongside IV fluids and allopurinol without TLS recurrence. Conclusions: Here, we highlight the importance of risk stratification, dose titration, and TLS prophylaxis with venetoclax use in RRMM.<\/jats:p>","DOI":"10.3390\/reports7040108","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T08:24:14Z","timestamp":1732868654000},"page":"108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tumor Lysis Syndrome with Venetoclax\/Carfilzomib\/Dexamethasone for Relapsed\/Refractory Multiple Myeloma: A Case Report"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6318-4255","authenticated-orcid":false,"given":"Reilly","family":"Fankhauser","sequence":"first","affiliation":[{"name":"Medical Scientist Training Program, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0484-5903","authenticated-orcid":false,"given":"Adetola","family":"Kassim","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3222-4079","authenticated-orcid":false,"given":"Eden","family":"Biltibo","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1056\/NEJMra0904569","article-title":"The Tumor Lysis Syndrome","volume":"364","author":"Howard","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.amjmed.2003.09.045","article-title":"Pathophysiology, Clinical Consequences, and Treatment of Tumor Lysis Syndrome","volume":"116","author":"Davidson","year":"2004","journal-title":"Am. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1111\/j.1365-2141.2010.08143.x","article-title":"Recommendations for the Evaluation of Risk and Prophylaxis of Tumour Lysis Syndrome (TLS) in Adults and Children with Malignant Diseases: An Expert TLS Panel Consensus","volume":"149","author":"Cairo","year":"2010","journal-title":"Br. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1046\/j.1365-2141.1999.01467.x","article-title":"Tumour Lysis Syndrome Complicating High-Dose Treatment in Patients with Multiple Myeloma","volume":"105","author":"Fassas","year":"1999","journal-title":"Br. J. Haematol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5631","DOI":"10.1182\/blood-2018-99-114822","article-title":"Tumor-Lysis Syndrome in Relapsed or Refractory Multiple Myeloma Patients Treated with Proteasome Inhibitors","volume":"132","author":"Suzuki","year":"2018","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s12288-016-0731-6","article-title":"Tumor Lysis Syndrome in Multiple Myeloma: An Increasingly Recognized Risk\u2014A Report of Seven Cases","volume":"33","author":"Singh","year":"2017","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4066\/AMJ.2013.1592","article-title":"Spontaneous Tumour Lysis Syndrome in a Case of Multiple Myeloma\u2014A Rare Occurrence","volume":"6","author":"Saravu","year":"2013","journal-title":"Australas. Med. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9620520","DOI":"10.1155\/2016\/9620520","article-title":"Spontaneous Tumour Lysis Syndrome in a Multiple Myeloma","volume":"2016","author":"Huzmeli","year":"2016","journal-title":"Case Rep. Med."},{"key":"ref_9","first-page":"698","article-title":"ABT-199 for Chronic Lymphocytic Leukemia","volume":"12","author":"Seymour","year":"2014","journal-title":"Clin. Adv. Hematol. Oncol. HO"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1182\/blood-2017-06-788786","article-title":"Efficacy of Venetoclax as Targeted Therapy for Relapsed\/Refractory t(11;14) Multiple Myeloma","volume":"130","author":"Kumar","year":"2017","journal-title":"Blood"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/ajh.26083","article-title":"Targeting BCL-2 with Venetoclax and Dexamethasone in Patients with Relapsed\/Refractory t(11;14) Multiple Myeloma","volume":"96","author":"Kaufman","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1182\/blood-2017-06-788323","article-title":"Promising Efficacy and Acceptable Safety of Venetoclax plus Bortezomib and Dexamethasone in Relapsed\/Refractory MM","volume":"130","author":"Moreau","year":"2017","journal-title":"Blood"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1016\/S1470-2045(20)30525-8","article-title":"Venetoclax or Placebo in Combination with Bortezomib and Dexamethasone in Patients with Relapsed or Refractory Multiple Myeloma (BELLINI): A Randomised, Double-Blind, Multicentre, Phase 3 Trial","volume":"21","author":"Kumar","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3748","DOI":"10.1182\/bloodadvances.2020004146","article-title":"Phase 2 Study of Venetoclax plus Carfilzomib and Dexamethasone in Patients with Relapsed\/Refractory Multiple Myeloma","volume":"5","author":"Costa","year":"2021","journal-title":"Blood Adv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1365-2141.2004.05094.x","article-title":"Tumour Lysis Syndrome: New Therapeutic Strategies and Classification","volume":"127","author":"Cairo","year":"2004","journal-title":"Br. J. Haematol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1056\/NEJMoa1815281","article-title":"Venetoclax and Obinutuzumab in Patients with CLL and Coexisting Conditions","volume":"380","author":"Fischer","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4860","DOI":"10.1182\/bloodadvances.2020002593","article-title":"Safety of Venetoclax Rapid Dose Escalation in CLL Patients Previously Treated with B-Cell Receptor Signaling Antagonists","volume":"4","author":"Koenig","year":"2020","journal-title":"Blood Adv."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/7\/4\/108\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:42:38Z","timestamp":1760114558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/7\/4\/108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,29]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["reports7040108"],"URL":"https:\/\/doi.org\/10.3390\/reports7040108","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,29]]}}}