Hemorrhagic Pericardial Effusion and Cardiac Tamponade in B-chronic Lymphocytic Leukemia Treated With Ibrutinib: A Case Report.

There are few reports of non-malignant hemorrhagic pericardial effusion and cardiac tamponade in patients with B-chronic lymphocytic leukemia (B-CLL) who were not concurrently treated with an anticoagulant or an anti-platelet agent. We report the case of a 57-year-old woman with B-CLL treated for 54 months with single-agent ibrutinib who developed non-malignant hemorrhagic pericardial effusion and cardiac tamponade. She recovered after pericardiocentesis and the discontinuation of ibrutinib treatment. We conclude that the pathogenesis of her hemorrhagic pericardial effusion involved a combination of abnormal coagulation and platelet dysfunction typical of B-CLL, off-target kinase effects of ibrutinib on platelets, and serosal inflammation.