neutrophil Decline

[Eagles95]

I just went in for my quarterly checkup (on Zanibrutinib maintenance therapy) and my neutrophils declined meaningfully to put me into neutropenia. Curious if this has happened to others and what the causes were. Also, curious how it was treated. Thanks for all replies!

[lankisterguy Administrator Volunteer]

Hi Eagles95,

A drop in Neutrophils is common with starting treatment. It may take a CLL expert to sort out the best path forward.

You may find some usefull information by looking in the box on this page labeled: Related Posts

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Or by reading through some of the 270 past postings that mention it: healthunlocked.com/cllsuppo...

>

Len

[cajunjeff]

Hello Eagles95. Neutropenia is a common side effect of zanubrutinib. Your doctor will have a variety of strategies to deal with it, which may include pausing zanu, taking a reduce dose or neutropen injections. Good luck.

Brukinsa Side Effects

Generic name: zanubrutinib

Hematologic

Very common (10% or more): Decreased neutrophil count (up to 52%), lymphocytosis (up to 41%), hemorrhage/hematoma (up to 42%), decreased platelet count (up to 44%), decreased lymphocytes (up to 32%), decreased hemoglobin (up to 30%), neutropenia (up to 28%), decreased WBC count/leukopenia (up to 26%), increased leukocytes (up to 21%), thrombocytopenia (up to 16%), anemia (up to 14%)

drugs.com/sfx/brukinsa-side...l

[akirsch973]

I started taking Brukinsa in July 2024 and had no changes to my neutrophil count. However, a month after being titrated to the high (400 mg) dose of Venclexta in January 2025, I became neutropenic. My CLL specialist informed me that this is common with Venclexta and that the count should normalize within a couple of months. Sure enough it did and my neutrophil count returned to normal in March 2025. No intervention was needed.

[gardener58]

What do you mean by a "maintenance therapy"? I'm on Zanu, my numbers are good, so I'm wondering if I can take a reduced dose. Thanks

[AussieNeil Partner Administrator in reply to gardener58]

BTKi 'brutinib' treatments work so slowly, they are impractical for fixed term treatments on their own. Instead they are prescribed for as long as they continue to work to maintain control of the CLL cancer, i.e. "Maintenance Therapy". Some early ibrutinib trial participants have been on continuous maintenance therapy for over a decade.

Neil