CLL is a lymphoid stem cell cancer so why are my myleloid stem cell products falling so much?

[CaptRon1976]

I am on Acal for 10 months after 8 years on W&W, 13q unmutated. Doing well with minimal side effects. ALC coming down from >200,000 to less than 30,000 after 9 months in April. Going to Dana Farber next week.

My question is: if CLL is a lymphocyte cancer and lymphocytes come from lymphoid stem cells in bone marrow, I seem to be having a large impact on my Myeloid stem cell products. RBCs down, platelets down, neutrophils falling but still OK . Very curious to know why Basophils which find and destroy solid cancer cells are at absolute 0.0% monocytes: 0.0%. Eosinophils: 0.0% for the last few blood draws.

It seems that Acal is targeting a lot of myeloid stem cell products m, which if true is not helpful. It seems to make Acalabrutinib less targeted than I had hoped !

Ron

[AussieNeil Partner Administrator]

Don't confuse cell targeting and bone marrow suppression. Lots of drugs suppress bone marrow production, including NSAIDs.

Neil

[CaptRon1976 in reply to AussieNeil]

thanks Neil,

My only other daily meds are Zetia (which replaced statins) and losartan. I don't think these are marrow suppressing. 0.0% absolute basos, monos, and eos just doesn't seem desirable.

[AussieNeil Partner Administrator in reply to CaptRon1976]

Provided your neutrophils are adequate, I doubt your specialist would be too concerned at your basophils, eosinophils and monocytes being zero in one blood test.

Neil

[CaptRon1976]

I'll let you know next week after seeing Matt Davids at Dana Farber. It has been over the last 3 tests.

[SofiaDeo]

Acalabrutinib is marrow suppressing, and the side effects you listed are common. It can and does affect other stem cell lines. Look at the "hematologic" section under the side effects:

drugs.com/sfx/acalabrutinib...

[CaptRon1976]

thanks for the reply,

Sort of knew it, but still disappointing.

Thank you for your input.

Ron