Hello,
I have been reading your posts for the last several months and the time has come to me to write a post as well.
My father, 64 years old, has been diagnosed with Cll/Sll. It all started accidentally a year ago after blood test which showed his Hgb level was low: 10,4 and WBC was high. At first the doctors decided to W&W. There was a marrowbone biopsy made in the end of January which resulted at CLL, with suspicion of second illness- mielophybrosis. It was quite a shock for all of us, even more because the doctor was not certain about what was going on and as described it, it was pretty unusual case. However in March his platelets dropped, Hgb was 8,6 and doctors decided to start with Endoxan. We are based in Bulgaria. He had two courses of it within 3 months, because of COVID in April, which deteriorated his blood results even more. Endoxan resulted in decreasing his spleen with 4-5 cm, and since the middle of June my father started ramping up with Venetoclax. When he reached 400 mg Rituximab was included as well once per month. Up to this moment he has had 5 courses of it, because in August his bilirubin and ASL started to raise and there doctors decided to miss Rituximab that month until Hepatitis was excluded. From June to November Hgb varied from 10,5 to 9,6. November Venetoclax was lowered to 200 per day.
However this month his total bilirubin reached 40 ( the upper limit is 21) and Hgb was 8,6, the doctor explained to him that there was a hemolisys. After staying at hospital for 5 days and treatment, without Venetoclax last week TBil dropped to 30, and Hgb to 7,9. Since Friday he started V again - 200 mg per day. Doctors explained that if TBIL raises again this week (he will be checked on Wednesday) Venetoclax will be stopped for good.
I know it is a really long post. I will appreciate any opinion on this. Is there any one with same results after Venetoclax and can it be the culprit for this Hgb drop and Total Bilirubin raise.
Thank you and take care!