Zanubrutinib is an orally administered second-generation covalent inhibitor of Bruton tyrosine kinase that was recently approved by the US Food and Drug Administration for the treatment of chronic lymphocytic leukemia and small lymphocytic leukemia. It has been associated with significant major and minor bleeding events, including intracranial and GI hemorrhage and hematuria, with or without concurrent antiplatelet or anticoagulation therapy. We report a case of a 65-year-old man with relapsing chronic lymphocytic leukemia. He presented to us with repeated episodes of worsening dyspnea secondary to hemorrhagic pleural effusion 2 months after the initiation of zanubrutinib with concomitant apixaban use. On discontinuation of zanubrutinib after the second episode, he remained asymptomatic on further follow-up examination. Previously only described with the first-generation Bruton tyrosine kinase inhibitor, our case focuses attention on a rare adverse event and a first reported incidence, to our knowledge, of recurrent hemorrhagic pleural effusion associated with zanubrutinib in a patient with relapsing chronic lymphocytic leukemia.

中文翻译：

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Zanubrutinib 相关的慢性淋巴细胞白血病中复发性自发性出血性胸腔积液：病例报告。


Zanubrutinib 是一种口服的第二代布鲁顿酪氨酸激酶共价抑制剂，最近被美国食品药品监督管理局批准用于治疗慢性淋巴细胞白血病和小淋巴细胞白血病。它与严重的大出血和轻微出血事件有关，包括颅内和胃肠道出血和血尿，伴或不伴同时进行抗血小板或抗凝治疗。我们报告了一例 65 岁男性复发性慢性淋巴细胞白血病病例。他向我们介绍了在开始使用 zanubrutinib 并同时使用阿哌沙班后 2 个月继发于出血性胸腔积液的呼吸困难恶化的反复发作。在第二次发作后停用 zanubrutinib 时，他在进一步的随访检查中仍然没有症状。以前仅用第一代 Bruton 酪氨酸激酶抑制剂进行了描述，我们的病例将注意力集中在一种罕见的不良事件上，据我们所知，在复发性慢性淋巴细胞白血病患者中，与 zanubrutinib 相关的复发性出血性胸腔积液的发生率首次报道。