Time off Ibrutinib

[ElMaga]

I stop my ibrutinib before my covid vaccine with permission from my doctor. But no one can ever tell me how long after I get vaccine I should be off of ibrutinib for the vaccine to take hold. I've done this everytime and I get an excellent response (antibody test). But it would be good to know if it's 10 days? two weeks? I hope my question makes sense.

[AussieNeil Partner Administrator]

You need enough time for the naive B cells responding to the vaccination or booster to mature into plasma cells, as these aren't inhibited by the BTKi ibrutinib. It seems that it takes at least 2 weeks for peak production of the first produced immunoglobulin/antibody, IgM to occur. (We can't know how we specifically respond without daily immunoglobulin testing - we are all different.)

This paper from 2023 Immunoglobulins response of COVID-19 patients, COVID-19 vaccine recipients, and random individuals

ncbi.nlm.nih.gov/pmc/articl... notes, for healthy individuals, with my emphasis, "The peak IgM response in COVID-19 patients was detected early at 15–22 days, followed by IgG peak at 16–30 days, and IgA peak at 0–60 days. IgM antibodies disappeared at 61–90 days, while IgG and IgA antibodies decreased slowly after the peak and remained detectable up to 300 days."

As I mentioned yesterday, healthunlocked.com/cllsuppo... if our bodies weren't regularly being challenged by new infectious agents, we wouldn't have any IgM. (IgM produced in response from the COVID-19 vaccination disappeared 2 to 3 months after vaccination.)

Interestingly, I was just reading a rebuttal of an anti-vaxxers argument that the date of vaccination should be used to differentiate vaccination response, not a few weeks afterwards. The anti-vaxxer didn't appreciate or acknowledge the time it takes for our bodies to gain protection from vaccinations and boosters.

Neil

Theoretical illustration of immune response to vaccine and booster showing booster benefit

[CaptRon1976 in reply to AussieNeil]

A little confused Neil.

If it takes 2-4 weeks for peak production of IgM and IgG to reach peak production, are we advised to stop BTKs weeks before and after covid shot? That seems a very long time off treatment. I am wondering why my cll specialists don’t discuss this.

Ron

[AussieNeil Partner Administrator in reply to CaptRon1976]

I agree, plus more time is needed off beforehand. That's why not many specialists support this approach.

Neil