Cardiovascular (CV) adverse events (AEs), especially atrial fibrillation (AF) and
hypertension, have been reported in patients receiving treatments for chronic lymphocytic
leukemia (CLL), including Bruton's tyrosine kinase inhibitors (BTKis). Although these
AEs are managed effectively in most cases and AE management guidelines exist, practical
management approaches are inconsistent across regions and practices. We aimed to address
these inconsistencies by developing consensus recommendations.A European expert panel
was assembled comprising eight hematologists and six cardiologists. Literature analysis,
expert interviews, and the Delphi method were used to gain consensus on screening,
monitoring, and treatment of AF and hypertension statements.Maintaining BTKi treatment
is paramount to maximize time to next treatment; for patients at high risk of progression,
this can be achieved by appropriately treating hypertension and AF and adjusting the
BTKi dose. Patients should be risk-stratified as low, moderate, high, or very high
risk of cancer therapy-related CV toxicity and treated according to their disease
status so that CLL treatment can be maintained. Patient education on symptom monitoring,
home blood pressure monitoring, and electrocardiograms (baseline, every 3 months)
are recommended to detect/monitor AF and hypertension. Close collaboration between
hematologists and cardiologists is vital to achieve optimal patient outcomes.
