@bosunpup, I'm not surprised that you're not finding much information about LMD or acalabrutinib. For patients who haven’t been treated for CLL before, acalabrutinib is a targeted therapy. It is a kinase inhibitor that affects the growth of CLL cancer cells. Kinases are part of the chemical pathways within cells, some of which can start the growth of new cells. Kinase inhibitors help stop growth signals and reduce the number of new cancer cells being made.

I assume (but you should confirm with the oncologist) that acalabrutinib will also target the cancer cell that have spread to the meninges and control the LMD. These are good questions to ask his care team at his next appointment. How frequently do you have follow-up appointments?