Ibrutinib-associated tumor lysis syndrome in a patient with mantle cell lymphoma: A case report

J Oncol Pharm Pract. 2017 Apr;23(3):235-239. doi: 10.1177/1078155216637218. Epub 2016 Jun 23.

Abstract

Mantle cell lymphoma accounts for 5-7% of all non-Hodgkin's lymphomas. Under the current WHO classification, it is categorized as an indolent B cell lymphoma, but has an aggressive clinical course. New insights into leukemogenic molecular pathways of mantle cell lymphoma have uncovered unique therapeutic targets. Ibrutinib, a Bruton's tyrosine kinase inhibitor, is the newest drug in the arsenal that has shown promising efficacy in relapsed mantle cell lymphoma. Long-term studies have shown that grade 3 or 4 adverse events are infrequent. Asymptomatic lymphocytosis is frequently seen with ibrutinib use in mantle cell lymphoma; however, tumor lysis syndrome is an extremely rare complication. To date, only two patients with ibrutinib-associated tumor lysis syndrome in mantle cell lymphoma have been described in a long-term follow-up study. Both patients met laboratory criteria for tumor lysis syndrome, however, but did not develop clinical tumor lysis syndrome. We, here describe a patient with relapsed mantle cell lymphoma who developed clinical tumor lysis syndrome with ibrutinib monotherapy.

Keywords: Ibrutinib; mantle cell lymphoma; tumor lysis syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adenine / analogs & derivatives
  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Humans
  • Lymphoma, Mantle-Cell / drug therapy*
  • Male
  • Piperidines
  • Protein Kinase Inhibitors / administration & dosage*
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrazoles / adverse effects*
  • Pyrazoles / therapeutic use*
  • Pyrimidines / adverse effects*
  • Pyrimidines / therapeutic use*
  • Tumor Lysis Syndrome / genetics*

Substances

  • Antineoplastic Agents
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • ibrutinib
  • Adenine