Management of adverse events associated with idelalisib treatment in chronic lymphocytic leukemia and follicular lymphoma: A multidisciplinary position paper

Hematol Oncol. 2019 Feb;37(1):3-14. doi: 10.1002/hon.2540. Epub 2018 Sep 5.


The introduction of new therapeutic agents in chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL), including the new kinase inhibitor idelalisib, has changed the therapeutic landscape of these diseases. However, the use of idelalisib is associated with a peculiar profile of side effects, which require an optimization of the current approach to prophylaxis and supportive treatment. Moving from the recognition that the abovementioned issue represents an unmet need in CLL and FL, a multidisciplinary panel of experts was convened to produce a consensus document aiming to provide practical recommendations for the management of the side effects during idelalisib therapy for CLL and FL. The present publication represents a consensus document from a series of meetings held during 2017. The Panel generated clinical key questions using the criterion of clinical relevance through a Delphi process and explored 4 domains, ie, diarrhea/colitis, transaminitis, pneumonitis, and infectious complications. Using the consensus method, the Panel was able to shape recommendations which may assist hematologist to minimize adverse events and guarantee adherence to treatment in patients with CLL and FL candidate to receive idelalisib.

Keywords: adverse events; chronic lymphocytic leukemia; follicular lymphoma; idelalisib.

Publication types

  • Review

MeSH terms

  • Aldehyde Oxidase / metabolism
  • Algorithms
  • Animals
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Colitis / diagnosis
  • Colitis / etiology
  • Cytochrome P-450 CYP3A / metabolism
  • Diarrhea / diagnosis
  • Diarrhea / etiology
  • Disease Management
  • Drug Interactions
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Follicular / drug therapy*
  • Lymphoma, Follicular / metabolism
  • Purines / adverse effects*
  • Purines / pharmacokinetics
  • Purines / therapeutic use
  • Quinazolinones / adverse effects*
  • Quinazolinones / pharmacokinetics
  • Quinazolinones / therapeutic use


  • Antineoplastic Agents
  • Purines
  • Quinazolinones
  • Cytochrome P-450 CYP3A
  • Aldehyde Oxidase
  • idelalisib