My mother (82yo) broke the neck of her right femur one month ago and had a total hip replacement (total hip arthroplasty) few days later. She was on ibrutinib for around 3 and half months already before that and it was suspended for almost 4 week because of this event. Now ibrutinib is resumed (since last Friday).
She is now (there are a couple of weeks) back home going through physiotherapy and re-learning how to walk and from the surgery point of view it was a success (but she overcame many complications during post-surgery recovery, in special during the first ten days, like urinary tract infection, very severe constipation, water in the lungs, stopped urinating for while requiring a catheter insertion , etc...). Now the bone biopsy came back and it seems the fracture was caused by cll infiltration. Initially the doctors thought it could be osteoporosis.
Her WBC and RBC are now quite reasonable and still recovering. Her spleen seems to have diminished considerably and she is not feeling any pain. Still feeling fatigue but seems to be improving.
She has an appointment with her hematologist) in two weeks.
While all the other indications seem to show ibrutinib is/was working and disease is/was shrinking could the cll infiltration on the bones indicate it is not working (i.e disease is progressing) or could the damage to the bone have occurred prior to ibrutinib? What to expect now? A pet scan? How are they going to find if there is more damage caused by cll in other bones or organs and if it is progressing despite of ibrutinib and blood counts showing good improvement?
Many thanks for your help!!!!!
Ibrutinib ..Sore Infected Fingers (paronychia)
on Ibrutinib for less than 2 weeks and lymph node in my neck have gone from silver $ size and about 3/8 inch thick toa little larger 
Farewell
UPDATE: Mom's CLL transformed to PLL
CLL with CNS involvement 
