I have been dealing with CLL since 2003 and had various chemo treatments, last being Treanda/Rituxan combo that knocked it down for a bit Roughest time I had was my spleen swelling on me, which has happened twice. The first time I recall severe pain, like having a knife inside me and someone twisting it. It took narcotics to make it tolerable. Second time my spleen went goofy seemed to happen for no reason, being that I was taking Imbruvica. This seems to be a great maintenance drug but the discomfort I get in my joints seem to be the main side effect. I never get any swelling/inflammation.. but more just achy which seems connected to level of activity. NSAIDs don't phase that, so narcotics dull that as well. Really getting tired of pill to pill existence and wonder it anyone changed from imbruvica to * ACT196 (going from memory here). From what I recall reading its similar to imbruvica but doesn't stay in the bloodstream long and maybe less side effects?