Ibrutinib Induces a Dramatic Improvement for Idiopathic Refractory Ascites Following Allogeneic Hematopoietic Cell

Kumiyo Tazoe1, Mitsutaka Nishimoto1, Akira Yamamoto2

  • 1Hematology, Graduate School of Medicine, Osaka Metropolitan University, Japan.

We herein report a case of idiopathic refractory ascites following allogeneic hematopoietic cell transplantation that was successfully treated with ibrutinib. A 39-year-old man presented with massive transudative ascites. Despite a high portal venous pressure, the liver histology showed traces of alloreactivity inconsistent with veno-occlusive disease/sinusoidal obstructive syndrome. Ibrutinib was administered for ascites possibly secondary to portal hypertension associated with the alloreactivity. The ascites dramatically improved, and the portal venous pressure was reduced. This case may help clarify the mechanism through which refractory ascites develops after allogeneic hematopoietic cell transplantation and establish appropriate treatment protocols.