Crizotinib and lymphocytopenia - 1264446

jmpchic
Posts:34

My husband has been on Xalkori for almost 3 years now. His absolute lymphocyte counts have been trending down he was 0.8 for about a year, dropping to 0.6 over the last few months and labs today down to 0.4 with his overall WBC 3.2 and ANC 2.2. Is this a concern for dosing changes? He has very minimal side effects just occasional lower extremity edema and diarrhea. He has been progression free for almost 4 years (scan today) so we really don’t want to change what is working! Has anyone else experienced lymphocytopenia?

Forums
Full Archive

Reply # - June 17, 2014, 06:58 PM

Dr West
Posts: 4735

Congratulations on such a nice, long benefit with XALKORI!

I have had occasional patients with cytopenias on XALKORI, sometimes requiring holding drug for a week here or there, then resuming it. The package insert actually says that it isn’t necessary to change dosing of XALKORI for low lymphocyte counts except in the presence of “opportunistic” infections — i.e., infections you don’t normally get unless you’re immunosuppressed.

-Dr. West

Reply # - June 18, 2014, 05:36 PM

jmpchic
Posts: 34

Thanks for the info. He has done really well. Today he told me that he is experiencing increased fatigue. He has been working more and kind of attributed it to that. But, he feels like this is true "exhausting fatigue" that he just can't shake. I know xalkori can lower testosterone, but we've never had his checked because the side effects of replacement testosterone were a little worrisome, but now I'm wondering if that could be it. Thyroid checks out normal. Do you routinely check testosterone on your male patients in xalkori?

Reply # - June 18, 2014, 09:21 PM

Dr West
Posts: 4735

No, but I might start. It's not standard yet, and it's not clear what you'd do about it. Most patients won't opt to stop XALKORI if there aren't prohibitive side effects.

-Dr. West

Previous PostNext Post