Will taking Venetoclax lower my white blood cells?

BCL-2 inhibition with venetoclax analogs and venetoclax was shown to cause neutropenia in rats, exacerbate taxane-induced neutropenia, and inhibit granulocyte colony formation in human bone marrow samples. Additionally, neutropenia, which has been previously documented in heavily pretreated patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin lymphoma in the trial, may be a class effect of BCL-2 inhibitory drugs.

The potent and selective BCL-2 inhibition exhibited by venetoclax, particularly its targeted inhibition of BCL-2 in neutrophil precursors, is likely to contribute to the observed neutropenia. Optimal neutropenia management should consider the grade and frequency of adverse effects. If grade 3 or 4 neutropenia associated with infection/fever occurs for the first time, it is recommended to interrupt venetoclax therapy until recovery to grade 1 or baseline levels and then administer venetoclax at the pre-interruption dose. For a second/subsequent event, venetoclax should be interrupted and subsequently resumed according to dose reduction guidelines. For severe neutropenia, growth factor support should be provided according to the medical institution's standards.

The original drug of Venacla is already on the market in China and can be found in the Category B medical insurance directory. The price of each box of 100mg*14 tablets may be around RMB 5,000. The Turkish version of the original drug Venekra, which is marketed overseas, has a specification of 100mg*112 tablets and the price per box is around RMB 10,000 (the price may fluctuate due to the exchange rate), which is even more expensive. Cheaper generic drugs are also sold overseas, and their pharmaceutical ingredients are basically the same as those of the original drugs. The price of a box of 100mg*120 tablets produced by a Bangladeshi pharmaceutical factory is around RMB 4,000 (prices may fluctuate due to exchange rates).