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CLL Support Association
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Neutropenia with Ibrutinib

I wonder if anyone experienced neutropenia with Ibrutinib and how it was managed in such a case.

My father was taken off Venetoclax due to a limited response and developing neutropenia. He is currently on Ibrutinib and his neutrophils are going down again at an alarming rate. His neutrophils restored and were stable. I saw the 3yo posts with similar problems but nothing recently. The doctor says it is very unlikely to be linked to Ibrutinib. Yet, neutropenia is stated as one of the side effects. Otherwise, the response to Ibrutinib is fine so far with manageable AFIB.

del17p/TP53, unmutated, IGH/BCL3 translocation t(14;19)(q32;q13.3)), PET-CT (taken 3 days ago) showed neither secondary cancer nor Richter.

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Good to hear your father is faring fairly well on Ibrutinib. How neutropenic is he? G-CSF injections (Filgrastim, Neulasta, Neupogen, etc) are given during chemo treatment to boost the neutrophil count to a safe enough level for the next treatment round, but Ibrutinib is an indefinitely prescribed maintenance drug. Changing to a neutropenic lifestyle would be wise if his neutropenia is severe enough (below 1.0).

ThreeWs, what responses have you heard of in such cases?

Neil

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Thank you, Neil! He fell from 1.6 to 0.4 since he started. He took the first G- CSF injection yesterday. All the doctors say this should not be happening with Ibrutinib since it is not classified as Chemo.

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Is he seeing a specialist? Chemo or not it is happening to your father. Ask his doctors about taking Claritin before and for a few days after his injections. It often helps prevent or lessen related bone pain.

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Hi Artkula, I became neutropenic after two years on Ibrutinib and had to be hospitalised for a few days. The problem was resolved by a reduction of my IB dose from 420 mg (3 pills) to 2 pills (280 mg) a day.

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Hi artkula! I read that your father had neutropenia taking Ibrutinib. My mother is in the same situation. It would be very nice if you can tell me how did you father managed with it. Thank you

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Sorry to hear that. The neutropenia was temporary (3 weeks). G-CSF helped to cope with it. It was not the case with Venetoclax, where G-CSF did not bring a stable response in our case and we had to withdraw from it.

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