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Perioperative Bleeding Associated With Ibrutinib in Dermatologic Surgery: A Case-Control Study
Nessa Aghazadeh1, Mauricio F Jin2, Renee L Pride1
1Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Summary
Ibrutinib treatment increases bleeding risk during dermatologic surgery, especially in older men with low platelets. Consider temporarily stopping ibrutinib before skin procedures.
Area of Science:
- Oncology
- Dermatology
- Hematology
Background:
- Ibrutinib, a Bruton tyrosine kinase inhibitor, is linked to higher bleeding risks.
- Limited data exists on ibrutinib's bleeding risk during dermatologic surgery.
Purpose of the Study:
- To assess the frequency of bleeding complications in patients undergoing dermatologic surgery while on ibrutinib.
Main Methods:
- Retrospective, single-center, case-control study.
- Compared 37 patients on ibrutinib undergoing skin surgery with 64 matched controls.
- Data collected from January 2013 to March 2020.
Main Results:
- Ibrutinib use was associated with a significantly higher rate of bleeding events (8% vs 0.8%, p=0.02).
- Bleeding occurred more in older male patients with lower platelet counts.
- Patients experiencing bleeding were older (mean 82.7 vs 73.0 years) and had lower platelets (104.0 vs 150.5 K/μL).
Conclusions:
- Ibrutinib may increase bleeding risk in dermatologic surgery patients, particularly older men with low platelets.
- Transient discontinuation of ibrutinib may be advisable before dermatologic procedures.
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