Calquence related skin problems

[Sandlot]

Last week I saw a post about Calquence decimating a person’s skin. I can’t find the post now but I had never made the connection to Calquence and my prematurely aging skin that has always been healthy. Anyone else?? I do get many bruises and red marks.

[lankisterguy Volunteer]

Hi Sandlot,

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If the mention of skin was in the original post, you may be able to find the posting with this link: healthunlocked.com/cllsuppo...

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I had an itchy skin rash on Ibrutinib in 2015, and later in 2016, a milder rash on Venetoclax. So we treated it with Phototherapy (lightbox UVB rays) for the last 1.5 years.

In January 2022 I added Calquence / Acalabrutinib, but have not seen a significant increase in the rash beyond a slight up tick when I reduced the Phototherapy from 3X per week to 1X per week.

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Len

[AussieNeil Partner Administrator]

Bruising and red marks (if by which you mean small red dots just under the skin called petechiae) can certainly occur with BTKi drugs such as acalabrutinib/Calquence. It's one of the side effects I had, but the incidence reduced with time as my platelets improved from their low of 29. The reason these side effects happen is that there are a number of tyrosine kinases used by our body. BTKis (Bruton's Tyrosine Kinase inhibitors) can to a lesser extent also inhibit these other tyrosine kinases, including one present in platelets. That's why clotting effectiveness can be impacted, hence the bruising and petechiae. It's better with the later generation BTKi drugs, such as acalabrutinib, as off target inhibition is reduced compared to ibrutinib. Other than the incidence of development of high blood pressure, the other side effects seen with BTKi drugs does decrease over time, though I note you've been on acalabrutinib for 2 years now. If your CLL is well under control, see if your specialist will consider reducing your dose.

Neil

[Arro]

I bruise easy and get petechiae, but less than when i first started calquence. Sun is my enemy tho, just a short stay in the sun burns my skin, i think it is a caution with calquence to watch out for sun exposure...i may be wrong about that so don't quote me on that one. As far as premature aging, i do not have a problem with that.