Major Surgery and Imbruvica

[Margobleu]

My husband has been on Imbruvica for 2 months and has now been told he needs a hip replacement for worsening hip pain. Has anyone else on Imbruvica had major surgery? Is a hip replacement even a possibility?

[Psmithuk]

I'm sorry I can't answer your question, I can see it is a concern. I hope someone with knowledge can answer your question.

[terryI_uk]

I am on ibrutinib and due for shoulder surgery mid January, I have to stop medication 7 days before and after surgery, I think this is the recognised procedure for this drug, maybe good idea to speak to your haematologist, Terry

[AussieNeil Partner Administrator]

Your husband will need to get his CLL specialist and surgeon talking. The surgeon will want to know how healthy his blood counts are - in particular his platelet levels (bleeding risk) and his general immunity so he can be appropriately covered to prevent infections. He'll need to go off Imbruvica prior to surgery per a standard protocol for major surgery.

Please let our community know how you get on getting your husband's specialists talking and the outcome, as I'm sure others will be very interested to know how he goes.

Neil

[Lenny123]

Just had hernia surgery, stopped 7 days before and about to restart 7 days after. it seems to have been wisest. While on Ibrutanib, minor cuts ad bruises took a long time to heal. It slows healing, can cause bleeding.

Concern is if stopping briefly will cause a flare up. It seems if one is in remission for some time, maybe over a year, there is less risk.

So many unknowns with this new medication, which has so many effects. Definitely coordinate with your oncologist and do not be afraid to have them check with one of the world experts. this is important for the average oncologist will only have a few patients on the medication. World specialists have many more.

[Fant1924]

Very interested in this because I need a hip replacement also and I have been on Imbruvica for 14 months. Wore mine out running marathons and 80,000 miles. I have looked hard to find a surgeon trained to do a resurfacing procedure that preserves bone but the few skilled ones seem reluctant to do that on an old guy, 70. Please keep us posted.

Dennis, Auburn, AL, 70, 17p-

[freddog]

After only a month on Imbruvica I fell and broke my leg, requiring emergency surgery. Fortunately, my care team at my local hospital got in touch with my hematologist at MD Anderson, who said to stop my Imbruvica for 4 days and then restart. There seem to have been no ill effects from doing this. You are lucky enough to have some lead time, so I'd recommend that you get communications started now. Also I'd inform the place where the surgery is to be done that your bloodworm will look alarming (at my place it set their hair on fire!), lest they start transfusing you and all kinds of other things!

Good luck!

[Cllcanada Top Poster CURE Hero]

If there has been any prior exposure to fludarabine, cladrabine, bemdamustine, pentostatin, etc, you want to advise all parties to use ONLY IRRADIATED BLOOD and blood products.

in CLL this includes FR, FCR, bendamustine/rituxan [BR], PCR etc.

Transfusion related Graft verses Host disease is rare, but purine analog drugs mentioned increases the risk...

~chris

[annsathome]

My husband has been on Ibrutinib for just over 2 years and has had several surgical procedures including a hernia op. All went well, stopping the Ibrutinib before and after. He is having his second hip replaced in Feb, his other was done 3 years ago just before his diagnosis of CLL which has been very successful. So I am hoping for the same good results so that he can get back on the golf course!!!

Good luck to your husband, hope all goes well.