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Concerned medication change was early and possibly unnecessary. Should other tests have been done before the change?

Ask the Doctor Question:

I have SLL. I was switched from ibrutinib (had taken for almost 5 years) to Claquence (now taken 1-1/2 weeks) with only a few changed blood markers:

  • WBC went from 11.2 to 20.8
  • Absolute Lymphocytes from 6.83 to 14.4
  • Platelets from 200 to 159
  • Absolute Eosinophols from 0.3 to .42
  • LDH from 210 to 239
  • No other marked changes

None of these seem high enough to me to change my medication. No other testing was done. My two favorite doctors (ARNP’s) are gone – one for other opportunities, one for maternity leave. I see a new ARNP on Monday. I’m an information person and advocate for myself as I believe it is necessary. I’m concerned this medication change was early and possibly unnecessary. Should other tests have been done before the change?

Answer: We are with you in that we are not sure why the medication change occurred, except for that acalabrutinib tends to have less side effects than ibrutinib.