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4CPS-073 Desensitisation to ibrutinib in a patient with serious late reaction: a case report
  1. R Tamayo Bermejo,
  2. L Yunquera Romero,
  3. M Nieto Guindo,
  4. I Muñoz Castillo
  1. Regional University Hospital of Málaga, Pharmacy Department, Málaga, Spain


Background and importance The use of a desensitisation protocol (DP) allows tolerance to drugs to which a hypersensitivity reaction has occurred, allowing treatment options which in some cases are the only ones available.

Aim and objectives Describe the use of a DP for ibrutinib in a patient with limited treatment options.

Material and methods 67-year-old woman with stage IV chronic lymphatic leukemia, not a candidate for transplantation, with a history of relapse to previous treatments. After 14 months of treatment with ibrutinib with good tolerance, a serious late reaction arose with a generalised purpuric rash of several days of evolution, and arthromyalgia that required hospitalisation and drug discontinuation, with subsequent clinical resolution.

Intradermal test for differential diagnosis of allergy versus late cutaneous adverse reaction was not conclusive for sensitisation to ibrutinib and a DP was proposed based on Phadke et al.1

Results Ibrutinib capsules were dispersed in purified water. A DP was performed with both hospital and home administration. Daily doses were administered 1 hour apart (table 1).

Abstract 4CPS-073 Table 1

The patient returned to the usual treatment with good tolerance.

Conclusion and relevance The DP allowed continuation with ibrutinib, with safety and good tolerance, without loss of this therapeutic option.

References and/or acknowledgements 1. Phadke NA, et al. Immediate reaction to ibrutinib amenable to oral desensitization. J Oncol Pharm Pract 2021;27(7):1802–1805.

Conflict of interest No conflict of interest

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