Toxicities
All patients experienced hematologic toxicity with grade 3-4 thrombocytopenia, anemia, and neutropenia. Non-hematologic Grade 3-4 adverse events (AEs) attributed to venetoclax are summarized inTable 3 . Five patients (38%) developed grade 3 or higher infections while receiving venetoclax. Four patients (23%) developed bacteremia due to uncommon organisms (Vignettes 1-2), one of whom developed four distinct episodes of bacteremia in addition to multiple other infectious complications (Vignette 2). Patient 13 developed Grade 4 encephalitis with multiple rim-enhancing brain lesions thought to be bacterial abscesses (Vignette 3). Two patients developed invasive pulmonary infections with Aspergillus. Two patients developed grade 3 skin infections. Patient 6, an infant, developed grade 3 nausea, which prompted discontinuation of venetoclax. No deaths occurred within 30 days of the start of venetoclax combination therapy, and no grade 5 AEs were reported as associated with venetoclax. No clinically significant tumor lysis syndrome was seen.
To demonstrate the wide spectrum of hematologic malignancies treated with venetoclax and the range of infectious complications that arose in our experience, we share the following vignettes.