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Are Body Cramps a Side Effect of CLL Treatment?

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Published on February 25, 2019

Patient Power community member Judy writes in, “Have there been any reports showing severe body cramping as a side effect from Ibrutinib?” During this Ask the Expert Segment, CLL expert Dr. Jeff Sharman, from The US Oncology Network, discusses the potential for chronic lymphocytic leukemia (CLL) patients to experience joint pains, cramps or spasms from treatment and provides strategies for side effect management. Watch now to hear his expert tips.

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Transcript | Are Body Cramps a Side Effect of CLL Treatment?

There is I think considerable question in the field.  There are differences amongst thought leaders on this as to whether—how to best manage it. 

There's some studies that suggest that lower dosages may—after a patient has been on ibrutinib for a length of time you may be able to get away with lower dosages.  Those pieces of clinical trial data are not as large and not as well validated, so I think it's still in the hypothesis?generating mode, but there's some data that suggest you could do it.  And if the choice was lower dose of ibrutinib or no dose of ibrutinib, I would probably go with a lower dose.  

The other potential solution now is acalabrutinib (Calquence), which is a second BTK inhibitor approved. It is approved by the FDA for mantle cell lymphoma.  However, a lot of the clinical trials are in chronic lymphocytic leukemia, and there have been studies that looked at patients who have limited tolerance of ibrutinib, and in many cases they were able to go on acalabrutinib without a recurrence of the same side effects.  

So that's another possibility. It is in the NCCN guidelines that for those patients who have intolerance of ibrutinib consider acalabrutinib.  So whether it's dose reduction or drug substitution, those are sometimes two ways that I use to get around that scenario.  

And I think that the feeling would be that should be a positive test and that it would eventually get CLL approval.  Most of the studies have been done in CLL.  It's just the mantle cell indication came along more quickly. 

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