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Perioperative Bleeding Associated With Ibrutinib in Dermatologic Surgery: A Case-Control Study.

Nessa Aghazadeh1, Mauricio F Jin2, Renee L Pride1

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Ibrutinib treatment increases bleeding risk during dermatologic surgery, especially in older men with low platelets. Consider temporarily stopping ibrutinib before skin procedures.

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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.