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Ibrutinib is an effective therapy for chronic lymphocytic leukemia and mantle-cell lymphoma (NEJM JW Oncol Hematol Jul 23 2013), but bleeding is a frequent complication. To investigate the effect of ibrutinib on platelet function and its association with clinical bleeding, a research team from France obtained clinical histories and performed platelet-function studies on 14 patients receiving the drug.
Platelet aggregation by collagen and collagen-related peptide was inhibited by ibrutinib, both in vitro and ex vivo. Mixing with normal platelets corrected the aggregation defect in proportion to the number of untreated platelets added. Incubation of normal blood with ibrutinib decreased platelet adhesion to a von Willebrand factor–coated matri…