Pleuropericardial effusion in CLL patients treated with ibrutinib: a causal relationship?

BJH - volume 12, issue 3, may 2021

A-S. Vander Mijnsbrugge MD, D. Wijsmans MD, V. Maertens MD


Ibrutinib is an inhibitor of Bruton’s tyrosine kinase used in the treatment of different B-cell malignancies. We describe a case of an 82-year-old woman with known chronic lymphocytic leukaemia (CLL) treated with ibrutinib who presented to the medical department with a symptomatic pericardial and pleural effusion. Extensive investigations were performed to rule out the most common aetiologies. Diagnosis of pleuro-pericardial effusion as an infrequently reported adverse effect of ibrutinib was made. Signs, symptoms, echocardiographic and radiographic abnormalities resolved steadily with anti-inflammatory therapy, pericardiocentesis, various thoracenteses and eventually surgical pleurodesis. Therapy with ibrutinib was definitively interrupted. A similar case of an 88-year-old male patient with stage IV mantle cell lymphoma was seen a few months later. These two cases suggest a causal relationship between therapy with ibrutinib and the onset of a symptomatic pleuropericardial effusion.

(BELG J HEMATOL 2020;12(3):132-7)

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Cyclic thrombocytopenia in a patient with polycythaemia vera: a case report

BJH - volume 9, issue 5, september 2018

I. Depoortere MD, V. Maertens MD, M. Criel , M. Vanden Driessche MD, I. Geerts MD


We present a case of a 73-year old patient with polycythaemia vera in whom cyclic thrombocytopenia was diagnosed. Strong fluctuations in platelet count, ranging from 31 to 1334 × 103/µL, were noticed after onset of hydroxyurea therapy. We did a literature search to find possible underlying causes of cyclic thrombocytopenia that could guide us towards a fast and appropriate diagnosis and an optimal treatment. In literature, provoked and unprovoked oscillations in platelet numbers have been described. Unprovoked oscillations can most likely be attributed to an unstable haematopoietic stem cell pool, as can be seen in polycythaemia vera. Provoked oscillations could be associated with myelosuppressive agents such as hydroxyurea. In both situations, a decrease in platelet count can be followed by a compensatory thrombopoietin-induced stimulation of megakaryocytes. Frequent hydroxyurea dose adjustments may be carried out in an attempt to control this cyclic pattern but, by contrast, may provoke a bouncing ball effect on platelet count. Certain patients will therefore benefit from maintaining therapy at a constant dose; while certain others require withholding or switching therapy. Cyclic thrombocytopenia is a rare finding and is frequently misdiagnosed as immune thrombocytopenia. If hydroxyurea-treated patients with a chronic myeloproliferative disorder present with thrombocytopenia, cyclic thrombocytopenia should be considered. Intensive follow-up with regular control of platelet count and personalised therapy is mandatory.

(BELG J HEMATOL 2018;9(5):188–91)

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P14 Cyclic thrombocytopenia in a patient with polycythemia vera: a case report

BJH - 2018, issue Abstract Book BHS, february 2018

I. Depoortere MD, V. Maertens MD, M. Criel , I. Geerts MD

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P2.18 Responding patients show durable responses to bendamustine in double refractory multiple myeloma patients

BJH - volume 5, issue Abstract Book BHS, january 2014

J. Caers MD, PhD, M.C. Vekemans MD, I. Vande Broek MD, PhD, V. Maertens MD, P.H. Mineur , G. Bries MD, PhD, E. Vandeneste , G. Vanstraelen , K. Beel MD, PhD, F. Leleu , H. Demuynck MD, C. Scheurmans , A. Van De Velde MD, W. Schroyens MD, PhD, K.L. Wu MD, PhD, N. Meuleman MD, PhD, R. Schots MD, PhD, M. Delforge MD, PhD, C. Doyen MD

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P.14 Bendamustin shows distinct anti-tumoural responses in multiple myeloma patients that relapsed after prior bortezomib and lenalidomide treatment. A study on behalf of the MM BHS subcommittee

BJH - 2013, issue BHS Abstractbook, january 2013

J. Caers MD, PhD, M.C. Vekemans MD, I. Vande Broek MD, PhD, P.H. Mineur , K. Beel MD, PhD, V. Maertens MD, C. Schuermans MD, F. Leleu , G. Vanstraelen , H. Demuynck MD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD, G. Bries MD, PhD, A. Van De Velde MD, M. Delforge MD, PhD, C. Doyen MD

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