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Leukemia

Making Memories That Matter With Chronic Lymphocytic Leukemia (CLL)

Mighty Partners
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When I started noticing bruising on my legs I thought, No big deal. Everyone gets bruises, right? Two years later, I had a routine checkup with my primary care provider (PCP), who took one look and said, “That’s not normal.” He ordered a complete blood count (CBC), a test that looks at the health of your blood cells, and called me a few days later. “You have chronic lymphocytic leukemia,” he said. I was shocked and immediately worried. All I heard was that I had leukemia.

What I didn’t understand at the time was that not all cancers are the same. Chronic lymphocytic leukemia (CLL) is a common form of leukemia in adults in the US. My PCP referred me to an oncologist. After a few more tests, I found out I had stage 4 CLL. Despite this diagnosis, my oncologist told me that CLL is a cancer that can often be managed thanks to currently available treatments. The important next step for me was to work with my care team to find the best management plan.

I followed up periodically with my oncologist, who would monitor my blood work and check my lymph nodes – areas in your body that make lymphocytes – to see if they were swollen. Everything seemed manageable for a few years during my “watch and wait” period until my blood test results showed changes.

My journey with CLL took a turn when I got a severe chest cold that taxed my immune system. Even after I recovered from the cold, my lymph nodes were still very swollen, I was experiencing heavy fatigue, and my belly felt so large that I couldn’t bend over. Something was wrong, and my oncologist confirmed that my blood test showed a change. It was time to try something new.

My oncologist talked with me about trying IMBRUVICA® (ibrutinib), a once-a-day oral prescription medicine used to treat adults with CLL. As someone with a chronic condition, I like to stay up to date with the latest research and resources available for CLL and I was familiar with IMBRUVICA®. We discussed the benefits and potential side effects that may occur while taking this treatment, including serious side effects, such as bleeding problems (hemorrhage), infections, heart rhythm problems (ventricular arrhythmias, atrial fibrillation, and atrial flutter), heart failure, death, high blood pressure (hypertension), decrease in blood cell counts, secondary primary cancers, liver problems, tumor lysis syndrome (TLS), and potential harm to an unborn baby, and the common side effects, including low platelet count; diarrhea; tiredness; muscle, bone, and joint pain; low white blood cell count; rash; low red blood cell count (anemia); bruising, and nausea.

Before taking any medicine, it’s important to understand its benefits and risks. Your doctor can help you learn more about what to expect before starting treatment with IMBRUVICA®. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Do not breastfeed during treatment with IMBRUVICA® and for 1 week after the last dose.

Your doctor could consider a dose adjustment to manage certain side effects so that you may continue to benefit from treatment, including pausing and then reducing your dosage. However, in some cases IMBRUVICA® will need to be stopped permanently.

Take IMBRUVICA® exactly as your doctor instructs.

My doctor started me on IMBRUVICA® and later transitioned me to a different dose after I experienced a rash. Since then, my CLL has been managed, and I have been excited for the opportunity to get back to doing the things I love, like spending time with my wonderful girlfriend, Sue.

My journey with CLL became even more meaningful when I discovered that my grandmother and aunt also had CLL, and unfortunately, my father recently passed away due to complications from small lymphocytic leukemia (SLL), a type of blood cancer similar to mine. Throughout my CLL journey, I have found great strength in connecting with others living with CLL. I’ve met so many wonderful people in person and on Facebook with similar experiences who, throughout their struggles, share messages of resilience and hope. Their positivity sparked a passion for advocacy in me, and I find joy in helping others impacted by B-cell malignancies.

Life with CLL is very different now than it used to be, and I feel lucky that treatment options are available to help manage my condition. For now, I’m focused on living my life with CLL and, for me, that includes travelling and quality time with Sue and my three kids.

Talk to your doctor about whether IMBRUVICA® is right for you and for more information on IMBRUVICA®, visit IMBRUVICA.com. Please see the Important Side Effect Information below and the full Important Product Information for more details.

Steve was paid by Pharmacyclics, an AbbVie Company, and Johnson & Johnson for sharing his experience and personal disease journey and treatment with IMBRUVICA®.

IMBRUVICA® is available as 70 mg and 140 mg capsules; 140 mg, 280 mg, and 420 mg tablets; and 70 mg/mL oral suspension.

USES

What is IMBRUVICA® (ibrutinib)?

IMBRUVICA® is a prescription medicine used to treat:

  • Adults with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL).
  • Adults with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) with 17p deletion.
  • Adults with Waldenström’s macroglobulinemia (WM).
  • Adults and children 1 year of age and older with chronic graft versus host disease (cGVHD) after failure of 1 or more lines of systemic therapy.

It is not known if IMBRUVICA® is safe and effective in children under 1 year of age.

IMPORTANT SIDE EFFECT INFORMATION

Before taking IMBRUVICA®, tell your healthcare provider about all of your medical conditions, including if you:

  • have had recent surgery or plan to have surgery. Your healthcare provider may stop IMBRUVICA® for any planned medical, surgical, or dental procedure.
  • have bleeding problems or are taking a blood thinner medicine.
  • have an infection.
  • have or had heart rhythm problems, smoke, or have a medical condition that increases your risk of heart disease, such as high blood pressure, high cholesterol, or diabetes.
  • have liver problems.
  • are pregnant or plan to become pregnant. IMBRUVICA® can harm your unborn baby. If you are able to become pregnant, your healthcare provider will do a pregnancy test before starting treatment with IMBRUVICA®. Tell your healthcare provider if you are pregnant or think you may be pregnant during treatment with IMBRUVICA®.
      •  Females who are able to become pregnant should use effective birth control (contraception) during treatment with IMBRUVICA® and for 1 month after the last dose.
      •  Males with female partners who are able to become pregnant should use effective birth control, such as condoms, during treatment with IMBRUVICA® and for 1 month after the last dose.
  • are breastfeeding or plan to breastfeed. Do not breastfeed during treatment with IMBRUVICA® and for 1 week after the last dose.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking IMBRUVICA® with certain other medicines may affect how IMBRUVICA® works and can cause side effects.

How should I take or give IMBRUVICA®?

  • Take or give IMBRUVICA® exactly as your healthcare provider tells you to take or give it.
  • Take or give IMBRUVICA® 1 time a day at about the same time each day.

IMBRUVICA® comes as capsules, tablets, and oral suspension.

  • If your healthcare provider prescribes IMBRUVICA® capsules or tablets:
      •  Swallow IMBRUVICA® capsules or tablets whole with a glass of water.
      •  Do not open, break, or chew IMBRUVICA® capsules.
      •  Do not cut, crush, or chew IMBRUVICA® tablets.
  • If your healthcare provider prescribes IMBRUVICA® oral suspension:
      •  See the detailed Instructions for Use that comes with IMBRUVICA® oral suspension for information about the correct way to take or give a dose. If you have questions about how to take or give IMBRUVICA® oral suspension, talk to your healthcare provider.
      •  Do not use if the carton seal is broken or missing.
  • If you miss a dose of IMBRUVICA®, take or give it as soon as you remember on the same day. Take or give the next dose of IMBRUVICA® at the regular time on the next day. Do not take or give extra doses of IMBRUVICA® to make up for a missed dose.
  • If you take too much IMBRUVICA®, call your healthcare provider or go to the nearest hospital emergency room right away.

What should I avoid while taking IMBRUVICA®?

  • You should not drink grapefruit juice, eat grapefruit, or eat Seville oranges (often used in marmalades) during treatment with IMBRUVICA®. These products may increase the amount of IMBRUVICA® in your blood.

What are the possible side effects of IMBRUVICA®?

IMBRUVICA® may cause serious side effects, including:

  • Bleeding problems (hemorrhage) are common during treatment with IMBRUVICA® and can also be serious and may lead to death. Your risk of bleeding may increase if you are also taking a blood thinner medicine. Tell your healthcare provider if you have any signs of bleeding, including: blood in your stools or black stools (looks like tar); pink or brown urine; unexpected bleeding, or bleeding that is severe or that you cannot control; vomit blood or vomit looks like coffee grounds; cough up blood or blood clots; increased bruising, or small red or purple spots on the skin; dizziness; weakness; confusion; change in your speech; or a headache that lasts a long time or severe headache.
  • Infections can happen during treatment with IMBRUVICA®. These infections can be serious and may lead to death. Tell your healthcare provider right away if you have fever, chills, weakness, confusion, or other signs or symptoms of an infection during treatment with IMBRUVICA®.
  • Heart problems. Serious heart rhythm problems (ventricular arrhythmias, atrial fibrillation, and atrial flutter), heart failure and death have happened in people treated with IMBRUVICA®, especially in people who have an infection, an increased risk for heart disease, or have had heart rhythm problems in the past. Your heart function will be checked before and during treatment with IMBRUVICA®. Tell your healthcare provider if you get any symptoms of heart problems, such as: feeling as if your heart is beating fast and irregular; lightheadedness; dizziness; shortness of breath; swelling of the feet, ankles, or legs; chest discomfort; or feeling faint. If you develop any of these symptoms, your healthcare provider may do tests to check your heart and may change your IMBRUVICA® dose.
  • High blood pressure (hypertension). New or worsening high blood pressure has happened in people treated with IMBRUVICA®. Your healthcare provider may start you on blood pressure medicine or change current medicines to treat your blood pressure.
  • Decrease in blood cell counts. Decreased blood counts (white blood cells, platelets, and red blood cells) are common with IMBRUVICA®, but can also be severe. Your healthcare provider should do monthly blood tests to check your blood counts.
  • Second primary cancers. New cancers have happened during treatment with IMBRUVICA®, including cancers of the skin or other organs.
  • Liver problems. Liver problems, which may be severe or life-threatening, or lead to death, can happen in people treated with IMBRUVICA®. Your healthcare provider will do blood tests to check your liver before and during treatment with IMBRUVICA®. Tell your healthcare provider or get medical help right away if you have any signs of liver problems, including stomach pain or discomfort, dark-colored urine, or yellow skin and eyes.
  • Tumor lysis syndrome (TLS). TLS is caused by the fast breakdown of cancer cells. TLS can cause kidney failure and the need for dialysis treatment, abnormal heart rhythm, seizure, and sometimes death. Your healthcare provider may do blood tests to check you for TLS.

The most common side effects of IMBRUVICA® in adults with B-cell malignancies (CLL/SLL and WM) include low platelet count; diarrhea; tiredness; muscle, bone, and joint pain; low white blood cell count; rash; low red blood cell count (anemia); bruising; and nausea.

The most common side effects of IMBRUVICA® in adults or children 1 year of age and older with cGVHD include tiredness; low red blood cell count (anemia); bruising; diarrhea; low platelet count; muscle, bone, and joint pain; fever; muscle spasms; mouth sores (stomatitis); bleeding; nausea; stomach pain; pneumonia; and headache.

Diarrhea is a common side effect in people who take IMBRUVICA®. Drink plenty of fluids during treatment with IMBRUVICA® to help reduce your risk of losing too much fluid (dehydration) due to diarrhea. Tell your healthcare provider if you have diarrhea that does not go away.

These are not all the possible side effects of IMBRUVICA®. Call your healthcare provider for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/PatientAccessSupport to learn more.

Please see the full Important Product Information.

 

US-IMBC-240515

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