Published in:
01-11-2019 | Chronic Lymphocytic Leukemia | Letter to the Editor
Ibrutinib related bleeding complications in elderly patients with B cell malignancies
Published in: Journal of Thrombosis and Thrombolysis | Issue 4/2019
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Ibrutinib is an inhibitor of Bruton’s tyrosine Kinase (BTK), an enzyme involved in B cells maturation and proliferation.
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Increased rate of bleeding, including major bleeding is reported on Ibrutinb, the true reasons are not fully understood. On one side, Ibrutinib display a potent antiplatelet activity due to inhibition of collagen and von Willebrand factor-on the other side platelets also express both BTK and TEC which helps to activate platelet.
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Here we report our experience with elderly lymphoproliferative patients treated with Ibrutinib focusing on bleeding complications. Data show that on Ibrutinib, risk factors for bleeding are female gender, previous history of bleeding, concomitant use of antiplatelet or anticoagulation agents, renal insufficiency and polypharmacy. Ibrutinib could be used with caution, both in the young and in the elderly with similar percentages of major bleeding events.