伊布替尼,一种不可逆的布鲁顿酪氨酸激酶抑制剂,与出血风险增加有关。关于依鲁替尼接受皮肤科手术的患者出血风险的数据很少。
目的确定接受皮肤手术的患者与依鲁替尼相关的出血并发症的发生率。
回顾,单中心,2013年1月至2020年3月期间接受ibrutinib皮肤手术患者的病例对照研究与性别比较,疾病,和年龄匹配的接受皮肤手术的对照患者。
共包括对37例患者进行的75例手术和对64例对照患者进行的116例手术。Ibrutinib与出血事件发生率显著增加相关(6/75[8%]vs1/116[0.8%],p值=.02)。与未发生出血事件的依鲁替尼患者相比,ibrutinib上流血的都是男性,年龄较大(平均年龄82.7vs73.0,p值=0.01),平均血小板计数较低(104.0vs150.5K/μL,p值=.03)。
依鲁替尼可能与血液系统恶性肿瘤患者的出血风险增加有关,尤其是血小板水平较低和使用多种抗凝剂的老年男性。皮肤科手术应考虑暂时停用依鲁替尼。
Ibrutinib, an irreversible Bruton tyrosine kinase inhibitor, has been associated with an increased risk of bleeding. There is a paucity of data on the risk of bleeding in patients on ibrutinib undergoing dermatologic surgery.
To determine the frequency of bleeding complications associated with ibrutinib in patients undergoing dermatologic surgery.
A retrospective, single-center,
case-control study of patients on ibrutinib undergoing skin surgery between January 2013 and March 2020 compared with sex, disease, and age-matched control patients undergoing cutaneous surgeries.
A total of 75 surgeries performed on 37
case patients and 116 surgeries performed on 64 control patients were included. Ibrutinib was associated with a statistically significant increased rate of bleeding events (6/75 [8%] vs 1/116 [0.8%], p -value = .02). Compared with ibrutinib patients who did not have a bleeding event, those on ibrutinib who suffered bleeding were all men, older (mean age 82.7 vs 73.0, p -value= .01), and had lower mean platelet counts (104.0 vs 150.5 K/μL, p -value = .03).
Ibrutinib may be associated with increased risk of bleeding in patients with hematologic malignancies, particularly older men with lower platelet levels and on multiple anticoagulants. Transient discontinuation of ibrutinib should be considered for dermatologic surgeries.