Ibrutinib‐associated rash: a single‐centre experience of clinicopathological features and management

Abstract

. (2015) Association of an alpha-globin gene cluster duplication and heterozygous betathalassemia in a patient with a severe thalassemia syndrome. Hemoglobin, 39, 102-106.

Optimising outcomes for patients with chronic lymphocytic leukaemia on ibrutinib therapy: European recommendations for clinical practice

“…In Phase III clinical trials of ibrutinib in CLL, any grade rash was reported in 8% of patients in the RESONATE study and grade ≥3 rash was reported in 3% of patients in RESONATE‐2 (Byrd et al , ; Burger et al , ). While most of the current understanding of ibrutinib‐associated rash comes from individual case reports (Mannis et al , ; Jensen et al , ), reports of larger patient groups being assessed for clinicopathological features, treatment methods and outcomes are starting to emerge (Iberri et al , ). It is the authors' experience that most patients who develop rash have prior history of hypersensitivity to other agents.…”

How I treat CLL patients with ibrutinib

“…Rash is a common ibrutinib side effect in 2-27% of patients 3,5,24,28 , but is often self-limited or easily managed with topical steroids 74,75 . A case series of 14 patients has been published from Stanford, in which two categories of rash were identified 74 .…”

“…A case series of 14 patients has been published from Stanford, in which two categories of rash were identified 74 . The first was a non-palpable asymptomatic petechial rash, perhaps related to ibrutinib-induced platelet dysfunction, while the second was a palpable pruritic rash which on biopsy showed an inflammatory infiltrate.…”

“…The first was a non-palpable asymptomatic petechial rash, perhaps related to ibrutinib-induced platelet dysfunction, while the second was a palpable pruritic rash which on biopsy showed an inflammatory infiltrate. The latter sometimes required ibrutinib interruption and corticosteroids to resolve but all patients were eventually able to resume ibrutinib 74 . More recently, erythema nodosum has been seen in ibrutinib-treated patients and may require systemic steroids and/or extended time off ibrutinib for resolution.…”

Dose‐limiting stomatitis associated with ibrutinib therapy: a case series

“…However, the rate of grade ≥3 adverse events remains low and treatment discontinuation due to toxicity (Byrd et al , , ) is uncommon and mostly related to infections (Byrd et al , , ; Burger et al , ; Puła et al , ; Tran & O'Brien, ). Dermatological toxicities have also been reported in 2–27% of treated patients (Ransohoff & Kwong, ; Iberri et al , ), mainly mild‐to‐moderate rash, neutrophilic panniculitis, progressive hair and nail changes, skin infections, bruising, petechiae and purpuric eruption (Fabbro et al , ; Bitar et al , ; Ransohoff & Kwong, ; Iberri et al , ). In contrast, oral toxicity with ibrutinib has rarely been described.…”