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The World’s Leading Authority for Chronic Lymphocytic Leukemia Patients

Concern about the toxicity of Ibrutinid and the possible non-response or discontinuation on Ibrutinib.

Ask the Doctor Question:

My husband is a CLL patient and on 5/12/2021 he started treatment with Ibrutinib. After two-months, today we were informed of his analytical results:

WBC decreased from 191*10^e/ul to 181*10^3/ul.

Lymohocites decreased from 153*10^3/ul to 152*10^3/ul.

Both are non-significant reductions.

Also, bad news with his red Blood cells:

HGB and platelets which decreased from 3,87*10^6/ul to 3,51*10^6/ul, 13,4 gr/dl to 11,7gr/dl and 137*10^3/ul to 95*10^3/ul, respectively.

We are concerned about the toxicity of Ibrutinid and the possible non-response or discontinuation on Ibrutinib. I would like to know your experienced opinion.

I would also like to ask you about the interruption of my husband workouts. He rides in MTB 3-4 days per week and does some muscle exercises. Should he stop doing that intense sport with his low HGB levels?

Answer: As far as workouts go, exercise is typically not contraindicated. The main thing to take into consideration is how he is tolerating it. For instance, if he becomes extremely winded right away or his heart rate increases rapidly, then exercising would be ill‑advised at this time.

Additionally, since we don’t have access to your husband’s previous lab values, medication regimens, or symptoms, we unfortunately cannot make any determinations about toxicity. Please speak with your healthcare provider about your concerns, as they will have access to all of your husband’s past labs. Please keep in mind trends in his lab results are typically much more important than any one or two lab values.

If you have any questions about what the normal lab values are, you can look at this section of our website. Additionally, many patients find it helpful to use our lab trending tool where you can enter your lab values and watch them trend over time in one place. That can be found on our website here.