Ibrutinib

[Broadbent]

This is my third week on ibrutinib, will, at some time my immune system get better? Or is this something I will have to deal with forever. Your comments would be appreciated

[Cllcanada Top Poster CURE Hero]

Imbruvica (ibrutinib) works very slowly... as the nodes start to clear, the absolute lymphocyte count [ALC] level will rise considerably, then after a few months the level will start to drop...

Hopefully your CLL specialist is monitering your progress, but it might take a number of months before your immune system starts to reverse.

~chris

[AussieNeil Administrator]

There was recently considerable excitement when an improvement in some immunoglobulin counts was observed in Ibrutinib patients: medpagetoday.com/Hematology...

That's unusual in CLL treatment, because all CLL treatments wipe out B-Lymphocytes, both good cells and CLL clones. Normally B-Lymphocytes mature into plasma cells, which make immunoglobulins, which is why treatment knocks down immunoglobulin (antibody) levels. There was hope a few years ago that Lenalidomide/Revlimid treatment would boost the immunity of CLL patients, but the trial results were lacklustre.

In summary, CLL is a cancer of the immune system and currently can't be cured. One of the main reasons watch and wait is recommended rather than starting treatment at diagnosis is that deferring treatment reduces the patient's risk of infections (and early death) from treatment. CLL specialists are working hard to find a cure (it costs too much to keep people on Ibrutinib indefinitely and side effects are a significant cause of people ceasing to take it), so eventually I expect those taking Ibrutinib will be offered a short term combination therapy that will provide a long remission if not a cure. Meanwhile, appreciate having access a non-chemo drug that has less impact on your immunity than alternatives.

Neil

[richutchens in reply to AussieNeil]

Very well said. Great explanation

[MrMidnight]

I've been taking a new generation form of Ibrutinib BGB-3111 for 14 months. I've needed a week's antibiotics almost every month for recurrent chest infections and sinusitis. But I haven't needed any for the past three months. My specialist said he thought that might happen as my blood counts and nodes cleared.

Hope it works for you in that way as well.

[richutchens]

I'm on my 6th cycle. Not a life sentence. Know that this is a fantastic drug. We are so fortunate it's available. Doing fine so far. You will too.

[Hoffy]

I am on Ibruvica currently. And going to add Venetoclax next months as part of the clinical trial.

If I get to MRD negative should my immune system and IVIG improve with the CLL cells being gone ?