Cdiff and pancolitis during ibrutinib treatment

[790727]

My husband started ibrutinib the end of July after about 3 weeks he started having issues with diarrhea which is one of the side effects so we really didn’t think much about it. His symptoms became progressively worse, after approximately 3 weeks he was diagnosed with cdiff and pan colitis He has since stopped the ibrutinib and started antibiotics for cdiff. Is this something that would have been caused by ibrutinib? I’m just wondering if anyone has experienced this.

[crystalsky]

Ibrutinib suppresses the immune system thereby making one more susceptible to infections. So, since your husband was healthy going into treatment, I would certainly say the Ibrutinib is suspect. It’s a powerful drug.

I wish your husband a quick recovery.

[lankisterguy in reply to crystalsky]

i must differ with Crystalsky, many treatments for CLL, especially Chemo and Rituxan do affect parts of your immune system and deplete your "good" B-cells, but Ibrutnib and most of the targeted drugs don't have that effect, in general.

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Most of us start treatment when our bone marrow is crowded with CLL cells and our marrow is not making enough red blood cells and enough neutrophils. Unfortunately for most of us, it takes several weeks to months for our marrow to recover, and during that time we can be neutropenic, and very susceptible to infections.

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Ibrutinib and most of the other targeted drugs do have side effects causing diarrhea for a portion of patients, and that can upset our gastro system balance of healthy bacteria, and that could lead to C-diff. C-diff can occur after repeated use of antibiotics, and can be treated by reintroducing the beneficial bacteria by a stool transfer.

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For some patients there seems to be a small improvement in the immune system during long term use of Ibrutinib, and some clinical studies/trials are trying to quantify if this perception is real and measurable.

Len

[crystalsky in reply to lankisterguy]

I still have the printout given to us when my husband started Ibrutinib. One of the bullet points is: "You may have more chance of getting an infection. Some infections have been deadly." Just saying.

[lankisterguy in reply to crystalsky]

That is correct, but I was disagreeing with your blanket statement that Ibrutinib depresses the immune system.

There is data that lung fungal infections are more likely with Ibrutinib, and even more substantial with Idelalisib.- I had pneumocystis while on Idelalisib. A clinical trial for previously untreated patients on Idelalisib was halted due to some deaths from pneumocystis. The mechanism of the increased incidence is not understood, but it does not appear to be the same route as steroids or rituxan which each are different means of exposure.

Len

[dongra]

Yes, had same issue after 9 months on that Med., was taken off that Med for 30 days, my doctor switched me to VENCLEXTA. The new Med is working. That is a side effect. Good Luck, many meds for treatment of CLL, that is the good news.