Ventoclax

[581959]

Hi

I’m on ventoclax first week my white blood cells didn’t drop much, I’m feeling a bit depressed

[joinf]

Hi 581959

Please don’t feel so depressed. Give ventoclax time to work. Remember it’s only been a week. I’m on Ibrutinib and have been told if and when it doesn’t work for me then my haemotologist will recommend ventoclax.

Hang in there 581959 and good luck.

Regards joinf 👍

[581959 in reply to joinf]

Thanks!

[MelioraDay]

The first week of Venetoclax is only 20 mg daily. You will gradually ramp up to 400 mg daily over 5 weeks. They start Venetoclax VERY slowly to prevent rapid lymphocyte destruction which could lead to tumor lysis syndrome. Therefore if your white blood cells dropped a lot at the end of the first week that would not necessarily be a good thing. They want this process to be slow and gradual. They didn't even check my CBC until the end of my second week on Venetoclax. By then my white count had come down quite a bit but was still not normal. At four weeks my labs were all normal, but everyone is different in how they respond to any medication. So keep your spirits up and let us know in a few weeks how things are going. Best wishes!

[581959 in reply to MelioraDay]

Thank you !

[closh]

My ALC dropped fairly quickly on Venetoclax at first and then it was a slow process to drop the last bit. My Dr said the weak cells die off quickest (I thought it might have been the older cells) then the tougher ones take some time. Anyway, they all died off in the end and that's what matters.

You're on 1/20th of the normal dose and so it's certainly no time to be worried. If your ALC is dropping in a few more weeks and continues to trend down towards normal levels, that's what you want.

Relax (and keep drinking lots of water) - it doesn't sound like anything to worry about yet.

Graham

[581959 in reply to closh]

Thanks

[lankisterguy Volunteer]

Hi 581959,

As Meloriaday and closh said, your ALC will probably drop suddenly after one of the ramp ups in week 2 or 3.

Mine hardly moved at 20 mg. dose- the first week, but my ALC dropped by 100k between the 50mg and 100mg doses week 2. My nodes disappeared between 100mg and 200mg in week 3. My blood was MRD negative on the 400 mg full dose, at week 29, the first time we tested for MRD.

Please be patient, the slow ramp up is intentional to protect you, since some patients in early trials started at 100mg and had life threatening reactions to the drug.

Len

[581959]

Thank you