Hello.
From what I gather so far on the internet cd49d + makes it more difficult for ibrutinib to do its job and suggests shoter overall survival. Do you find this to be a useful marker? Does it imply anything else? Trying to tease bits of info out of dense articles.
Does anyone take any drugs that block vla-4 to make sure ibrutinib is not bypassed? Is that even possible?
Been reading: sciencedaily.com/releases/2...
Sounds like it is linked to Notch1?
nature.com/articles/leu2017296
This is interesting. I have not heard about it at all. I found ....
jem.rupress.org/content/ear...
which is similar. I had flow cytometry done in May and they didn't probe for CD49b. I guess I'm going to try to look into this. This must have come out from studies of people who did not respond well to IB, so its all fairly new.
From what I have read so far it is linked more to SLL and it is not commonly looked for in usa. An NIH test referenced it. My flow cytometry test from private practice doctor does not look for it.
CD49d expression has only recently been tested for and is associated with a poorer response to Ibrutinib. NOTCH1 is strongly correlated with Richter’s transformation and trisomy 12 is associated with both NOTCH1 and CD49d.
It would seem to be reasonable to test for CD49d prior to Ibrutinib treatment.
ncbi.nlm.nih.gov/pubmed/289...
bloodjournal.org/content/12...
It bypasses the ibrutinib through something called VLA-4. Perhaps one day they will find another drug that plugs that loophole.
jem.rupress.org/content/ear...
Noticed I was 48% positive for cd49d so a notch1 test is in order eventually.
They have that drug already, Zydelig (idelalisib). There are few trials looking at Imbruvica (ibrutinib) and Zydelig (idelalisib) used in combination...
~chris
Safety profile of Idelalisib is not good, too many pneumonitis and colitis SAEs with some deaths.
I don't know if you can predict who would get an 'itis' with it.
Yes... perhaps next gen duvelisib then... I had absolutely no problems on Zydelig (idelalisib)/rituxan, wish I could still be on it... 😀👍🏼 It simply requires prophylactics and CMV monitoring...
Deaths were first line when used with bendamustine... terrible mistake. It can't be used first line now at all...
~chris
Achy legs and CLL 
Living with CLL
Is 400 mg of venetoclax always better?
FCR?
Painful bruises on my hands 
