Ibrutinib-associated alveolar hemorrhage and spontaneous hemothorax

Ibrutinib is an irreversible inhibitor of Bruton’s tyrosine kinase (BTK), a cytoplasmic tyrosine kinase of the Tec family, which plays an important role in the B-cell receptor signaling pathway [1]. Ibrutinib is used for the treatment of chronic lymphocytic leukemia, mantle cell lymphoma, Waldenströ...

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Bibliographic Details
Published in:Kardiochirurgia i torakochirurgia polska 2022-03, Vol.19 (1), p.49-51
Main Authors: Tombul, Ismail, Sayan, Muhammet, Dundar, Nazlihan Boyaci, Dikyar, Asena, Yildiz, Seyma, Celik, Ali
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Alveoli
B-cell receptor
Bleeding
Blood
Brain
Bruton's tyrosine kinase
Chronic lymphocytic leukemia
Collagen
Dura mater
Glycoprotein VI
Glycoproteins
Graft versus host disease
Graft-versus-host reaction
Hematoma
Hemorrhage
Kinases
Letter to the Editor
Leukemia
Lung diseases
Lymphatic leukemia
Lymphocytes B
Macroglobulinemia
Mantle cell lymphoma
Meninges
Microvasculature
Protein-tyrosine kinase
Signal transduction
Stem cell transplantation
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Summary:Ibrutinib is an irreversible inhibitor of Bruton’s tyrosine kinase (BTK), a cytoplasmic tyrosine kinase of the Tec family, which plays an important role in the B-cell receptor signaling pathway [1]. Ibrutinib is used for the treatment of chronic lymphocytic leukemia, mantle cell lymphoma, Waldenström macroglobulinemia, and graft versus host disease [2]. Ibrutinib predisposes to bleeding by inhibiting BTK and Tec, which play a role in the inhibitory signaling pathway of platelet collagen receptors such as glycoprotein VI (GP VI) and C-type lectin-like receptor 2 (CLEC-2). In addition, ibrutinib has an inhibitory effect on the interaction of von Willebrand factor and glycoprotein-1b (GP 1b), and microvascular hemorrhages can be explained by this mechanism [3]. Cases of ibrutinib-related minor bleeding besides fatal hemorrhages such as subdural hematoma, gastrointestinal bleeding, and very rarely hemothorax, have been reported in the literature [2, 4]. Here, we aimed to present a case of ibrutinib-related alveolar hemorrhage and spontaneous hemothorax in a patient with pulmonary graft versus host disease due to allogeneic stem cell transplantation performed for acute lymphoblastic leukemia.
ISSN:1731-5530
1897-4252
DOI:10.5114/kitp.2022.114557