ibrutinib and increased WBC

[mobirdy]

80 year old. On ibrutinib for 5 months with great results until last blood work. WBC stopped going down and in fact went up slightly. Any one have this happen? What is the significance, if any?

[cllady01 Former Volunteer]

That happens with BTK inhibitors. My understanding is that your WBC that have been hiding in the lymph nodes and/or spleen are being pushed out by the BTK into the bloodstream and so raise the count. Your treatment is working!!! And your Dr. will be watching that and all other blood levels and should alert you if a problem arises.

There have been many postings by members with just that question.

Best wishes for a continued sweeping out of the B-cells and your feeling well in the process.

[mobirdy in reply to cllady01]

Thanks. Good explaination.

[AussieNeil Administrator]

Tracking your WBC count is not a very accurate way of determining what's happening with your CLL at any time and particularly as your WBC count decreases. That's because there are 5 different types of white blood cells making up your total WBC count. Each independently rise and fall, so without looking at what's called the differential - the breakdown of the different sub-counts, you won't know in particular has increased! This is why you need to track just your lymphocyte count, per this post: healthunlocked.com/cllsuppo... cllady01 noted, it's common (but not inevitable), for the lymphocyte count to rise for the first few months after starting on Ibrutinib and other, similar drugs. It can even stay high for a year without being of concern.

Since you haven't shared your absolute WBC counts, I can't be sure what actually changed, but if your WBC has dropped down under 20 to 30, your WBC increase could be simply due to an increase in your other WBC counts, most likely your neutrophils. They alone can quite healthily vary between 2 and 8, so an increase of 6 in your neutrophil count and a fall of 4 in your lymphocyte count could still result in an overall rise in your WBC.

Neil

[cajunjeff]

Good answers from cllady and Neil. Here is a short article that might help too:

communityview.lls.org/artic...

[mobirdy in reply to cajunjeff]

Thanks for the article. Very helpful info.

[mobirdy in reply to cajunjeff]

The article was very helpful. Thanks.

[morepork]

I'm on Ibrutinib since 2016 and, looking at my spreadsheet my absolute lymphocyte count yoyo's up and down between about 8.00 and 13.00, never getting into the "normal" range. (No nodes) . I understand a % of CLL'ers seem to have this pattern of continued lymphocytosis - and my haematologist and I are OK with this.

[mobirdy in reply to morepork]

Thanks for the helpful info.