Ibrutinib and lung infection

Ibrutinib and lung infection

Has anyone else experienced breathing difficulties while taking Ibrutinib?

I have been on Ibrutinib for about 18 months. It has worked wonderfully well. But I have had a minor cough, nasal inflammation and shortness of breath for about 10 months.

Blood tests, chest X Ray and ECG are clear. But I am told I have a lung infection, which is still being investigated. This may or may not be related to my CLL or the Ibrutinib I am taking.

If the infection cannot be addressed, my options seem to be to live with it; to stop taking Ibrutinib or to try a reduction in dose.

Has anyone else faced this problem?

7 Replies

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  • Your doctor should know the protocol when adverse events, infection or toxicity arise when taking Ibruitinib. The data is included in the drug insert. There's a clinical trial currently recruiting to gauge different doses and the the lowest effective dose of Imbruvica to prevent toxicity. I wish you the best and hope you get this bump in the road worked out!

    Clinicaltrials.gov Identifier NCT02801578

    clinicaltrials.gov/ct2/show...

    Link added - Admin

  • Many thanks. I'm seeing him next month and intend to discuss this then.

  • Have you considered calling and getting in sooner? I wouldn't hesitate to move your appointment up.

    Best Regards

    Lisa Minkove

  • Good idea!

  • I have taken Idelalisib, Ibrutinib and now Venetoclax and my CLL expert Doctor is always concerned about lung infections, since that is a major cause of death for CLL patients. I don't believe changing your Ibrutinib dose will improve your symptoms.

    Due to our immune compromised condition there are fungus and virus infections that are not normally found in people with "normal" immune systems. You should ask your doctor to test you and resolve this immediately, don't wait patiently, while this "is still being investigated"

    en.wikipedia.org/wiki/Pneum...

    Pneumocystis pneumonia (PCP) is a form of pneumonia, caused by the yeast-like fungus Pneumocystis jirovecii.[1]

    Pneumocystis pneumonia is not commonly found in the lungs of healthy people, but, being a source of opportunistic infection, it can cause a lung infection in people with a weak immune system. Pneumocystis pneumonia is especially seen in people with cancer undergoing chemotherapy, HIV/AIDS, and the use of medications that suppress the immune system.

    Signs and symptoms of PCP include fever, non-productive cough (because sputum is too viscous to become productive), shortness of breath (especially on exertion), weight loss, and night sweats. There is usually not a large amount of sputum with PCP unless the patient has an additional bacterial infection. The fungus can invade other visceral organs (such as the liver, spleen, and kidney), but only in a minority of cases.

    Pneumothorax is a well-known complication of PCP. An acute history of chest pain with breathlessness and diminished breath sounds is typical of pneumothorax.

    Disease course

    The risk of PCP increases when CD4 positive T-cell levels are less than 200 cells/μL. In these immunosuppressed individuals the manifestations of the infection are highly variable. The disease attacks the interstitial, fibrous tissue of the lungs, with marked thickening of the alveolar septa and alveoli, leading to significant hypoxia which can be fatal if not treated aggressively. In this situation LDH levels increase and gas exchange is compromised. Oxygen is less able to diffuse into the blood, leading to hypoxia. Hypoxia, along with high arterial carbon dioxide (CO2) levels, stimulates hyper-ventilatory effort, thereby causing dyspnea (breathlessness).

    Len

  • Many thanks for that very informative reply Len. I will get all of this checked out asap.

  • Diagnosed in 2009 6 months of chemo,remission until September 2015 relapse. Started on lbrutinib Oct 5 2016. Doing great except for this dry cough and sinus draining.Nothing seems to help so far.. I am 70 years old,great health,pilot instructor and can't and will not complain about the benefits of this trial. If anyone has similar or any ideas on how to help clear this cough please advise. Florida..

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