How do you adjust the dose of Ibrutinib in hepatic dysfunction, particularly if disease related?   

It's an interesting question, but I have never seen such a case. Ibrutinib rapidly clears tissue disease, and hence, the liver dysfunction, if truly CLL-related, should improve on therapy. Given the unusual scenario, I would consider starting at a low dose, 140 MG daily, and titrate up to 280 MG aft...