CLL Support Association
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Total Knee Replacement

I was diagnosed with CLL in 2010

I have been on Imbruvica for past three years. I have had minor side effects like some black and blue marks and some Facial pimples that last About a week and then disappear. I now have to have TKR total knee replacement now and am concerned that for about 4-6 weeks on blood thinners. Does anyone have any info on this?

5 Replies

I had an experience with blood thinners and ibrutinib, but my case was due to A.fib. I was faced with a hemicolectomy and stopping Imbruvica (ibrutinib) etc., so have some experience in this area. I actually quit ibrutinib totally due to bleeding issues, so it was never a problem for my operation.

My one recommendation would be to be certain both your surgical team and CLL hemetologist are in close communication.

Don't assume that your surgeon has any knowledge of Imbruvica (ibrutinib) or how it interacts with blood thinners.

I would also suggest you discuss which type of thinner is used. Warfarin was contraindicated with Imbruvica (ibrutinib), but I noted from the revised drug label, that is no longer the case. No explaination either.

Warfarin has an antidote...Xarelto, which I was on, does not. Reversing the thinning effect of the drug might be an issue with surgery, you need this discussed.

Also there are recommended stop times for Imbruvica (ibrutinib), be certain your doctor has the latest data from the drug company as things have changed a bit ...

I'm sure everthing will be fine, Dave



Hi Chris,Thanks for the reply. What happened to your CLL if you stopped taking the Ibrutinib? Did it return with all the symtems?



My CLL held for about 8 months, then my Hgb and platelet levels started down and the absolute lymphocyte count [ALC] escalator started up to 380K...

Now 16 months later all my bloodwork is in range... on Zydelig (idelalisib) and rituxan...minor colitis. I have been on treatment for 9 months...



Thank the Lord for that. By the way the rituxan is given by iv or tablet?


Rituxan is a monoclonal antibody... and they are all given by IV infusion... other MABs are ofatumumab and Gazyva (obinutuzumab) common in CLL


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