Calquence, diarrhea and pneumonia

[MeMario]

Hello,

My father, 84 years old, has non-Hodgkin's mantle cell lymphoma, diagnosed in 2017. He started Imbruvica in 2021, which was replaced a few months ago with Calquence because Imbruvica was no longer providing benefits but only side effects. With Calquence, lymphocytes are decreasing slowly, but they are decreasing, and platelets and red blood cells, although low, remain at least constant without transfusions.

I wanted to ask for your opinion on 2 issues:

1) Since starting Imbruvica, dad has always had a tendency to have diarrhea, let's say moderately. Now with Calquence, this situation has worsened, and when he goes to the bathroom, he rarely has well-formed stools. We've tried probiotics, prebiotics, lactic acid bacteria, but it's not improving. Has anyone of you had this problem, and how did you solve it, if you did?

2) Both Imbruvica and Calquence list pneumonia as a common side effect, and indeed, dad gets pneumonia once or twice a year, which is increasingly complicated to treat and with more long-term consequences, despite all the necessary vaccinations. I don't think there's a remedy for this side effect, do you have any advice? But my main question was different: is it true that during pneumonia, Calquence should be suspended? I would like to avoid suspending it because I've noticed that during the suspension and during pneumonia, the lymphocytes then increase more than they have slowly decreased during periods of therapy, and I think that suspending also accentuates the drug habituation effect, with the risk that Calquence will soon stop working too.

Thank you for your attention.