I have a question about Calquence ALC counts going up again

[helenolton]

I have been on Calquence for 16 days, I was happy because my ALC was coming down. It went to 335 when I first started Calquence, then went to 309, 179, 176. I took blood work today, and I just got the results went back up to 253. Has that happened to anyone else? Should it be coming down on every blood draw instead of going up?

[AussieNeil Administrator]

While it will be good to get feedback from others of their early days with Calquence, keep in mind that Calquence works gently. From experience with ibrutininlb, we know that even in people who see a slow trend down over a year compared to others who see their lymphocytes drop to around normal, BTK inhibitors are still working effectively, controlling CLL. In an early ibrutinib trial, getting to undetectable CLL (uMRD) was only achieved by ~10% after 4 years.

More importantly, how are your haemoglobin, platelet and neutrophil counts going? These can fall before improving.

Neil

[helenolton in reply to AussieNeil]

My Hemoglobin is low, but interestingly my platelets rose from 68 to 98. Has not been that high in two years. My platelets are still not in normal range , but I will take this as a sign that Calquence must be working. Worried because my ALC went up instead of down. I am getting blood draws three times a week. Not sure if everyone had gotten there blood drawn that often.

[AussieNeil Administrator in reply to helenolton]

You are being followed closely, primarily I suspect because your haemoglobin dropped into transfusion territory. Your platelet increase is a promising sign. When that increase is confirmed and your haemoglobin follows, provided your neutrophil count remains above 2.0, I expect that you'll be asked to reduce the frequency of your blood testing. I followed a similar pattern of blood testing on my clinical trial on AVO, during the venetoclax ramp up.

Neil

[helenolton in reply to AussieNeil]

Thank you