BTK inhibitors and IgG levels

[ikahan]

My husband had been on acalabrutinib for a few months. His IgG level has dropped from 7.4 ( low normal ) to 6.4 ( low ). His ALC has risen significantly but it's just starting to come down. I understand that Ibrutinib reverses T cell exhaustion and as the bone marrow clears out the immune system overall works better. However with continuing acalabrutinib use will the IgG eventually start rising or will ramain low ? If it remains low is my husband at increased risk of infection ?

Thanks, Ileana

[AussieNeil Administrator]

The IgG count is a simplistic measure of infection risk from previously experienced illnesses, or illness for which we've had vaccinations. The infection risk depends on whether someone has the specific antibodies to an illness to which they've been exposed and how well their immune system responds when antibodies label the invaders for destruction. That's why you need to have both low IgG (typically under 4), plus a history of recent serious infections - typically requiring hospital care, to qualify for IgG infusions.

Based on reported experiences with Ibrutinib, your husband's IgA and IgM may improve, while his IgG will probably not change much.

Neil

[ikahan]

Thank you so much, that was very helpful.

Ileana