eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2022
vol. 19
 
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abstract:
Letter to the Editor

Ibrutinib-associated alveolar hemorrhage and spontaneous hemothorax

Ismail Tombul
1
,
Muhammet Sayan
1
,
Nazlihan Boyaci Dundar
2
,
Asena Dikyar
3
,
Seyma Yildiz
3
,
Ali Celik
1

  1. Department of Thoracic Surgery, Gazi University, Ankara, Turkey
  2. Division of Critical Care Medicine, Department of Internal Medicine, Gazi University, Ankara, Turkey
  3. Department of Hematology, Gazi University, Ankara, Turkey
Kardiochirurgia i Torakochirurgia Polska 2022; 19 (1): 49-51
DOI: https://doi.org/10.5114/kitp.2022.114557
Online publish date: 2022/03/24
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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.
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