Intermittent fasting (IF) has recently gained popularity due to its emerging benefits in reducing weight and improving metabolic health. Concurrently, novel agents (NAs) like venetoclax and Bruton tyrosine kinase inhibitors (BTKIs) have revolutionized the treatment of chronic lymphocytic leukemia (CLL). Unfortunately, it is unclear whether the associated risks of tumor lysis syndrome (TLS) and gastrointestinal bleeding (GIB) are increased in IF practitioners receiving NAs. This review explored the literature available on the permissibility of IF in CLL patients undergoing treatment with first-line NAs (FLNAs). Literature was scoped to identify IF patterns and the available data on TLS and GIB risks associated with food and fluid intake in CLL patients receiving FLNAs. Although current evidence is insufficient to recommend IF in this population, it may be possible for patients on venetoclax to conservatively practice fluid-liberal IF, provided that adequate hydration and the consistent administration of food are achieved. In contrast, considering the significant risk of TLS and the pharmacokinetics of venetoclax, patients should be discouraged from practicing fluid-restricted IF, especially during the ramp-up phase. Moreover, patients on BTKIs ought to refrain from IF due to the possible risk of GIB until further data are available. Further research is needed to provide conclusive recommendations.
间歇性禁食（IF）因其在减轻体重和改善代谢健康方面的新兴益处而近期受到广泛关注。与此同时，维奈克拉和布鲁顿酪氨酸激酶抑制剂（BTKIs）等新型药物（NAs）已彻底改变了慢性淋巴细胞白血病（CLL）的治疗。然而，在接受NAs治疗的IF实践者中，肿瘤溶解综合征（TLS）和胃肠道出血（GIB）的相关风险是否增加尚不明确。本综述探讨了关于接受一线新型药物（FLNAs）治疗的CLL患者进行IF的可行性相关文献。通过文献梳理，识别了IF模式以及关于接受FLNAs治疗的CLL患者中与食物和液体摄入相关的TLS和GIB风险的现有数据。尽管现有证据不足以推荐该人群进行IF，但对于使用维奈克拉的患者，在确保充分补水和规律进食的前提下，可能可以谨慎实践允许液体摄入的IF。相反，考虑到TLS的显著风险及维奈克拉的药代动力学特性，应劝阻患者进行限制液体摄入的IF，尤其是在剂量递增阶段。此外，由于可能存在GIB风险，使用BTKIs的患者应避免进行IF，直至获得更多数据支持。需要进一步研究以提供明确的建议。
肿瘤(癌症)患者之家