Interrupting Acalabrutinib for a minor surgery

[MikeOr]

Acalabrutinib seems to increase the patient's propensity to bruising / bleeding even more, on the top of the already low platelet count. So it needs to be stopped before and after a minor skin surgery. Have any of you been in a similar situation, and if yes - how long was your interruption ?

[lankisterguy Volunteer]

Hi MikeOr,

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In the past my CLL expert doc has recommended 3 days before and after for minor skin surgery, and 7 days before and after for a major back operation (Ibrutinib & Calquence) no pause for Venetoclax.

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Len

[anon52]

For my last colonoscopy, my oncologist had me stop taking acalabrutinib four days before the procedure. I resumed the medication the day after the procedure.

[Pageboy]

How minor is the surgery? I had a BCC biopsy and didn’t stop the Acalabrutinib. All was fine. I then needed to have it removed and although it was small was advised to stop. Five days in total- 3 before, 2 after. Also had a colonoscopy and stopped 3 days before. Started again same day colonoscopy was done. For me, stopping for even this short time caused my lymph nodes to rush back. I am 11q deleted so this may have something to do with that. They went down again after a day back on and my blood work was not affected. A few days coming off is unlikely to be a problem.

[stevesmith1964]

Hi

I have stopped acalabrutinib for 3 ten day periods, surgery to remove a SCC from my nose and obviously had to stop for 10 days for 2 covid infections as covid depresses Platlets and thus higher risk of a PE if taking acalabrutinib.

[Vizilo]

I have not been advised to stop Acalabrutinib for minor surgery including tooth extraction and dental implants by a periodontist or excision of suspicious lesions by a dermatologist. In all cases, such procedures have been followed by a week of antibiotics as a precaution.

There was a recent exception though. My dermatologist sends away all extractions for biopsy. One just came back showing an aggressive carcinoma (sebaceous). My dermatologist has referred me to a plastic surgeon who will perform a more thorough “cleaning” of the spot (on my shin). For this surgery, my cll specialist advised stopping Acalabrutinib for the day before the surgery and the day of.

[barger1951]

I had to stop taking Ibrutinib for the same reason, I had been on it for about a year and a half. I felt so good off of IBR that I stayed off it for 3 years. My numbers actually got better for a time and my doctor told me I might as well stay off it, but all good things come to an end and I just started taking Acalabrutinib.