Pericarditis and Cardiac Tamponade in Patients Treated with First and Second Generation Bruton Tyrosine Kinase Inhibitors: An Underappreciated Risk.

Autor: Erblich T; Centre for Haemato-Oncology Barts Cancer Institute Queen Mary University, Charterhouse Square, London EC1M 6BQ, UK., Manisty C; Institute of Cardiovascular Sciences University College London, Gower Street, London WC1E6BT, UK., Gribben J; Centre for Haemato-Oncology Barts Cancer Institute Queen Mary University, Charterhouse Square, London EC1M 6BQ, UK.
Jazyk: angličtina
Zdroj: Case reports in hematology [Case Rep Hematol] 2024 Jul 09; Vol. 2024, pp. 2312182. Date of Electronic Publication: 2024 Jul 09 (Print Publication: 2024).
DOI: 10.1155/2024/2312182
Abstrakt: Introduction: The introduction of Bruton's tyrosine kinase (BTK) inhibitors significantly improved the management of chronic lymphocytic leukemia (CLL). However, BTK carry the risk of cardiotoxicity, which is not only limited to atrial fibrillation. Case Reports . We report three cases of patients on BTK inhibitors who developed acute pericarditis and cardiac tamponade. We report the first patient who developed this complication on treatment with zanubrutinib. This patient's treatment was changed to zanubrutinib due to atrial fibrillation. Shortly after cardioversion, he developed cardiac tamponade and shock. He underwent pericardiocentesis, received treatment for acute pericarditis with steroids and colchicine, and made a full recovery. We also report two further cases, both involving patients treated with ibrutinib. These patients also developed acute pericarditis and cardiac tamponade and required pericardiocentesis. All three patients discontinued BTK therapy following the events.
Conclusions: These three cases highlight the rare but potentially life-threatening risk of cardiac tamponade which can occur even with newer generations of BTK inhibitors. Haemato-oncologists should remain vigilant in patients who report dyspnea or who show sinus tachycardia on routine electrocardiography. Even in the absence of classical clinical signs of tamponade, patients require urgent evaluation with echocardiography and potentially emergency pericardiocentesis.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2024 Thomas Erblich et al.)
Databáze: MEDLINE
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