Severe bruising

[spanish36]

I have been taking Acalabrutinib in a clinical trial for three years achieving excellent results.

A few days back I tripped over uneven paving while enjoying my daily walk. I hit the concrete hard. Fortunately no broken bones.

By that evening a nasty bruise had appeared on my right side and abdomen. By next morning the bruise was significant.

I consulted with my GP and also with my clinical trial team who agreed I should cease taking my Acalabrutinib for three days. Which I did.

By next morning scary bruising covered my right mid side and a swollen edema had formed within the bruise. My GP ordered a CT Contrast Scan which showed that bruising was contained and not impacting other organs.

My GP directed me not to restart my Acalabrutinib for another four days and my blood thinner aspirin not for another week.

I was aware that Acalabrutinib contributes to bruising as does aspirin. However this huge and heavy bruising has given me a nasty fright.

I think it's now under control. I get reviewed by my GP in five days. I am a bit concerned about clots as I am off both the Acalabrutinib and aspirin but we have to stop the bruising from spreading.

Has anyone else on Acalabrutinib or brutinib suffered a similar experience and recovery?

I welcome any advice. Thanks.

Best regards

Ross

[jonathan7176]

I've had one or two livid bruises on acalabrutinib, which I just ignored, but nothing quite like that. I'll try not to fall off my bike! Hope it clears up soon.

[spanish36 in reply to jonathan7176]

Please dont fall off your bike. I hope to return to my circuit walks shortly. This time taking great care not to trip over uneven footpath. Never want a repeat of this enormous bruising, etc. Take care.

[country76]

When I was taking Ibrutinib I had severe cramping. One episode involved my left thigh. the muscle cramps were so bad and I couldn't get my muscles to relax. My whole thigh was solid black with bruising. I went to the ER with muscle still seizing. My son said I looked like I was hit by a car. That was the worst one. I am taking Alacabrutinib now and have small bruising now and then. No muscle cramping.

I also take 81mg coated aspirin and have for years.

[spanish36 in reply to country76]

Thanks country76. I havent experienced cramping due to Acalabrutinib. That would be painful. My medical folk reckon they have not sighted such massive bruising as this one before.

Anyway I'm on the mend thanks and a few lessons learnt.

All the best

Cheers

[country76 in reply to spanish36]

It was the Ibrutinib that gave me the most bruising. Alacabrutinib is working well for me.

[spanish36 in reply to country76]

Likewise I have rarely experienced bruising since commencing taking Acalabrutinib three years ago which has proved a great success for me. My numbers now approaching the normal ranges.

This massive bruising covering my entire right side is the result of my unfortunate accident. Apparently the Acalabrutinib plus my blood thinner encouraged this horrible bruising to expand.

Anyway I'm on the mend. I will watch with greater care where I walk in future

Thanks.

[AussieNeil Partner Administrator]

Hi Ross,

BTK inhibitors have an off target effect on the tyrosine kinase in platelets, affecting clotting, so some degree of bleeding/bruising is par for the course. That's why the recommendation to stop taking these drugs prior to surgery. I'd say that your situation was further complicated because you are also taking aspirin. Your medical advice to stop taking acalabrutinib was obviously appropriate, given your circumstances and your post is a good warning to others to be proactive after heavy bruising impacts.

Within the IMPORTANT SAFETY INFORMATION ABOUT CALQUENCE® (acalabrutinib) tablets on the official Calquence site calquencehcp.com is this statement;

"Use of antithrombotic agents concomitantly with CALQUENCE may further increase the risk of hemorrhage. In clinical trials, major hemorrhage occurred in 2.7% of patients taking CALQUENCE without antithrombotic agents and 3.6% of patients taking CALQUENCE with antithrombotic agents. Consider the risks and benefits of antithrombotic agents when co-administered with CALQUENCE. Monitor patients for signs of bleeding.

Consider the benefit-risk of withholding CALQUENCE for 3-7 days pre- and post-surgery depending upon the type of surgery and the risk of bleeding."

Neil

[spanish36 in reply to AussieNeil]

Thanks Neil for your informative reply. I was aware of the bruising side effect of Calquence but never imagined anything could be as massive as this bruise and edema . If it was possible I would have attached a photo. It's a shocker of a bruise and a warning to others to not repeat :))

Anyway my GP doesn't consider the danger of a clot/s on the move a risk since ceasing to take my blood thinning medication after receiving my CT Contrast Scan report.

On the mend and several lessons learnt by me.

Looking forward to returning to taking my Acalabrutinib capsules next week as my relative CLL levels are only slightly above normal and life is great! Three years to this point. Nearly there!

Thanks for your excellent forum and always helpful information.

Cheers

Ross

[onu1tadi2]

I just had an ultrasound of a leg that has been swollen for over a month after stumbling over a low steel barrier and falling. I had stopped taking acalabrutinib a few months before when in remission and was waiting for c scan result since i had swollen glands. I just started venatoclax 2 weeks ago. I was surprised how long the bruises took to start fading. The leg swelling is lessening now and it is no longer painful to walk after weeks of pain. I believe such accidents simply take a long time to heal from if you have CLL but eventually do heal. I think you can expect to heal. I would suggest you do not worry. Rest really helped. Because of bad air pollution I have been more sedentary which has helped.

[spanish36 in reply to onu1tadi2]

Thanks. Much appreciated. Sorry about your own accidental fall. Glad you are slowly on the mend.

I am sure my own set of bruising will heal in its own good time taking into account CLL.

My main concern was having to cease taking both my Acalabrutinib and aspirin. Both have blood thinning capabilities. I have coronary concerns.

I will be back on both medications in a few days so all will be okay.

Thanks and all the best.

Cheers

[onu1tadi2 in reply to spanish36]

I took and still take blood thinners (apixaban and metropolol) by the way for blood pressure and Afib that i got from ibrutinib that i took before acalabrutinib.

[spanish36 in reply to onu1tadi2]

Thanks for your update.