title: Successful treatment of ibrutinib-associated central nervous system hemorrhage with platelet transfusion support.
abstract: Ibrutinib is a novel targeted therapy for B-cell malignancies. Hemorrhagic events were reported in the original trials, however the mechanism of bleeding is just being elucidated. Recent studies have demonstrated platelet dysfunction as a mechanism of bleeding. Currently we report two patients who developed life-threatening central nervous system hemorrhage while receiving ibrutinib for chronic lymphoid leukemia (CLL) and mantle cell lymphoma, respectively. Both patients improved rapidly after platelet transfusions even though their platelet counts were normal or only mildly reduced at the time of hemorrhage. We suggest that platelet transfusions can ameliorate the platelet dysfunction defect of ibrutinib and can support the patient through the critical period until new platelet production occurs.
authors: Department of Medicine, New York Medical College, Valhalla, NY, USA ;
authors: Karen
authors: K
authors: Seiter
authors: Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA ;
authors: Michael F
authors: MF
authors: Stiefel
authors: Department of Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA.
authors: Jacqueline
authors: J
authors: Barrientos
authors: Department of Medicine, New York Medical College, Valhalla, NY, USA ;
authors: Azfar
authors: A
authors: Shaikh
authors: Department of Medicine, New York Medical College, Valhalla, NY, USA ;
authors: Nasir
authors: N
authors: Ahmed
authors: Department of Medicine, New York Medical College, Valhalla, NY, USA ;
authors: Paul
authors: P
authors: Baskind
authors: Department of Medicine, New York Medical College, Valhalla, NY, USA ;
authors: Delong
authors: D
authors: Liu
keywords: Ibrutinib; central nervous system hemorrhage; chronic lymphoid leukemia (CLL); mantle cell lymphoma; platelet dysfunction