Öz
Kronik lenfositik lösemi ve Mantle hücreli lenfoma da yeni bir tedavi seçeneği olan ibrutinib, yüksek etkinliği ile günümüzde sık kullanılmaya başlanmıştır. Hedefe yönelik monoklonal antikorların yan etkileri sitotoksik tedavilere göre daha hafif seviyede görülmektedir. İbrutinibin de ishal, bitkinlik, ateş, bulantı, kanama, sitopeniler, alerjik reaksiyonlar gibi yan etkileri görülmektedir. Kanama %50 den fazla vakada görülmüştür. Çoğunluğu peteşiyal kanamalar olmasına rağmen hayati tehdit eden kanamalara da yol açmaktadır. Bizde ibrutinibin kanamaya eğilimi olan hastalarda dikkatli kullanılmasını vurgulamak amacıyla, ibrutinib sonrası kanama gelişen vakamızı sunduk
Anahtar Kelimeler
Kaynakça
- Byrd JC, Furman RR, Coutre SE, Flinn IW, Burger JA, Blum KA, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med 2013;369:32-42.
- Ponader S, Chen SS, Buggy JJ, Balakrishnan K, Gandhi V, Wierda WG, et al. The Bruton tyrosine kinase inhibi- tor PCI-32765 thwarts chronic lymphocytic leukemia cell survival and tissue homing in vitro and in vivo. Blood 2012;119:1182-9.
- Byrd JC, Brown JR, O'Brien S, Barrientos JC, Kay NE, Reddy NM, et al. Ibrutinib versus ofatumumab in previous- ly treated chronic lymphoid leukemia. N Engl J Med 2014; 371:213-23.
- Byrd JC, Furman RR, Coutre SE, Burger JA, Blum KA, Co- leman M, et al. Three-year follow-up of treatment-naive and previously treated patients with CLL and SLL receiving single-agent ibrutinib. Blood 2015;125:2497-506.
- Wang ML, Blum KA, Martin P, Goy A, Auer R, Kahl BS, et al. Long-term follow-up of MCL patients treated with single-agent ibrutinib: Updated safety and efficacy results. Blood 2015;126:739-45.
- Levade M, David E, Garcia C, Laurent PA, Cadot S, Mic- hallet AS, et al. Ibrutinib treatment affects collagen and von Willebrand factor-dependent platelet functions. Blood 2014;124:3991-5.
- Kamel S, Horton L, Ysebaert L, et al. Ibrutinib inhibits col- lagen-mediated but not ADP-mediated platelet aggregati- on. Leukemia 2015;29:783-7.
Öz
Ibrutinib, a novel therapeutic agent with increasing use as a highly effective treatment in Chronic lymphocytic leukemia and Mantle cell lymphoma, is associated with a lower incidence of side effects as compared to cytotoxic agents due to its mechanism of action involving targeted monoclonal- antibodies. However, ibrutinib may also cause side effects such as diarrhea, fatigue, fever, nausea, bleeding, cytopenia, or allergic reactions. Bleeding has been reported to occur in more than 50% of the patients, mostly in the form of petechial bleedings. However, life-threatening bleeding may also occur. Herein, we report a case with bleeding occurring after ibrutinib treatment in order to underscore the importance of careful use of this agent in patients with a predisposition for bleeding
Anahtar Kelimeler
Kaynakça
- Byrd JC, Furman RR, Coutre SE, Flinn IW, Burger JA, Blum KA, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med 2013;369:32-42.
- Ponader S, Chen SS, Buggy JJ, Balakrishnan K, Gandhi V, Wierda WG, et al. The Bruton tyrosine kinase inhibi- tor PCI-32765 thwarts chronic lymphocytic leukemia cell survival and tissue homing in vitro and in vivo. Blood 2012;119:1182-9.
- Byrd JC, Brown JR, O'Brien S, Barrientos JC, Kay NE, Reddy NM, et al. Ibrutinib versus ofatumumab in previous- ly treated chronic lymphoid leukemia. N Engl J Med 2014; 371:213-23.
- Byrd JC, Furman RR, Coutre SE, Burger JA, Blum KA, Co- leman M, et al. Three-year follow-up of treatment-naive and previously treated patients with CLL and SLL receiving single-agent ibrutinib. Blood 2015;125:2497-506.
- Wang ML, Blum KA, Martin P, Goy A, Auer R, Kahl BS, et al. Long-term follow-up of MCL patients treated with single-agent ibrutinib: Updated safety and efficacy results. Blood 2015;126:739-45.
- Levade M, David E, Garcia C, Laurent PA, Cadot S, Mic- hallet AS, et al. Ibrutinib treatment affects collagen and von Willebrand factor-dependent platelet functions. Blood 2014;124:3991-5.
- Kamel S, Horton L, Ysebaert L, et al. Ibrutinib inhibits col- lagen-mediated but not ADP-mediated platelet aggregati- on. Leukemia 2015;29:783-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 27 Sayı: 1 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.