During imbruvica treatment my white count peaked in the low 40 Ks, absolute lymphocyte count 30 K plus, Prior to my first treatment, with Rituxan, lympocytes were over 150,000, lymphatic involvement very extensive, spleen enlarged with symptoms of ischemia. It was a question of treating the CLL or removing the spleen. After rituxan, lymphocyte count bottomed out at 1K, and rose to about 10K when I started imbruvica. On 2 occasions when I had clonal and total lymphocyte counts, at time of diagnosis and shortly after relapse (prior to imbruvica), the difference was about 1K per microliter, presumably consisting of normal b-lymphocytes plus T-cells, with T-cells predominating as they should. That would be a low T-cell count and a low count for normal b-cells. CLL is known to suppress T-cell counts as well as counts of normal b-cells. I've had serious problems with infections since about 6 weeks after starting imbruvica. However, I am resistant to starting IVIG again and want to see how things go at a reduced dose before re-visiting the issue of starting IVIG. I got very little benefit from IVIG when I was previously getting it for about 2 years. Imbruvica is a serious immune suppressant that is FDA approved treatment of chronic Graft Versus Host Disease. I am hoping that a dose reduction provides adequate relief from the immune suppressant features of imbruvica without rendering it ineffective as a CLL treatment.