{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:17:58Z","timestamp":1791670678566,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005205","name":"Janssen Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005205","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The Bruton tyrosine kinase inhibitor ibrutinib (IB) has attained an important role in the treatment of patients with chronic lymphocytic leukaemia, mantle cell lymphoma, and Waldenstr\u00f6m macroglobulinemia, significantly improving clinical outcomes. However, IB therapy has been associated with an increased risk of atrial fibrillation (AF) and bleeding. We report on the expert opinion that a group of Italian haematologists, cardiologists, and pharmacologists jointly released to improve the practical management of patients at risk for AF and bleeding during treatment with IB. A proper pretreatment assessment to identify patients who are at a higher risk, careful choice of concomitant drugs, regular monitoring, and multispecialist approach were characterized as the main principles of clinical management of these patients. For patients developing AF, anticoagulant and antiarrhythmic therapy must be guided by considerations about efficacy, safety, and risk of pharmacokinetic interactions with IB. For patients experiencing bleeding or requiring procedures that increase the risk of bleeding, considerations about platelet turnover, IB\u2010related platelet dysfunctions, and bleeding worsening by concomitant anticoagulants or antiplatelet agents provide clues to manage bleeding. Overall, AF and bleeding are manageable clinical events in patients receiving IB, not requiring drug interruption in most cases. Preexisting AF should not represent an absolute contraindication to IB therapy. For each patient candidate for IB, strategies of risk assessment and mitigation may allow to exploit the life\u2010saving effects of in chronic lymphocytic leukaemia and mantle cell lymphoma.<\/jats:p>","DOI":"10.1002\/hon.2503","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T06:39:13Z","timestamp":1520404753000},"page":"624-632","source":"Crossref","is-referenced-by-count":63,"title":["Practical management of ibrutinib in the real life: Focus on atrial fibrillation and bleeding"],"prefix":"10.1002","volume":"36","author":[{"given":"Giuseppe","family":"Boriani","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Corradini","sequence":"additional","affiliation":[{"name":"Dipartimento di Oncologia ed Emato\u2010oncologia Universita' degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Hematology Section, Department of Medical Sciences University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Falanga","sequence":"additional","affiliation":[{"name":"Department of Immunohematology and Transfusion Medicine \u201cPapa Giovanni XXIII\u201d Hospital  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Fo\u00e0","sequence":"additional","affiliation":[{"name":"Hematology, Department of Cellular Biotechnologies and Hematology Sapienza University, Policlinico Umberto I  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Gaidano","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Translational Medicine University of Eastern Piedmont  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Prospero","family":"Ghia","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Vita\u2010Salute San Raffaele and IRCCS Istituto Scientifico San Raffaele  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Martelli","sequence":"additional","affiliation":[{"name":"Hematology, Department of Cellular Biotechnologies and Hematology Sapienza University, Policlinico Umberto I  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Marasca","sequence":"additional","affiliation":[{"name":"Hematology Division, Department of Medical and Surgical Sciences University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Massaia","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Molecular Biotechnologies and Health Sciences University of Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Romana","family":"Mauro","sequence":"additional","affiliation":[{"name":"Hematology, Department of Cellular Biotechnologies and Hematology Sapienza University, Policlinico Umberto I  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Minotti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Center for Drug Sciences University Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Molica","sequence":"additional","affiliation":[{"name":"Department of Hematology\u2010Oncology Azienda Ospedaliera Pugliese\u2010Ciaccio  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Montillo","sequence":"additional","affiliation":[{"name":"Department of Hematology, Niguarda Cancer Center Niguarda Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pinto","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology and Stem Cell Transplantation Unit National Cancer Institute, Fondazione \u201cG. Pascale\u201d IRCCS  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Tedeschi","sequence":"additional","affiliation":[{"name":"Department of Hematology Niguarda Cancer Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Vitolo","sequence":"additional","affiliation":[{"name":"Citt\u00e0 della Salute e della Scienza Hospital and University, on behalf of FIL  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2112-2651","authenticated-orcid":false,"given":"Pier Luigi","family":"Zinzani","sequence":"additional","affiliation":[{"name":"Institute of Hematology and Medical Oncology \u201cSeragnoli\u201d University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.119123"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.144576"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400376"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509388"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70335-3"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00465-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306220"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501548"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-017-2973-2"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-606038"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"O'BrienSM FurmanRR CoutreS et al.Five\u2010year experience with single\u2010agent ibrutinib in patients with previously untreated and relapsed\/refractory chronic lymphocytic leukemia\/small lymphocytic leukemia. Presented at: 58th American Society of Hematology Annual Meeting; San Diego CA; December 3\u20106 2016. Abstract 233.","DOI":"10.1182\/blood.V128.22.233.233"},{"key":"e_1_2_9_13_1","unstructured":"EORTC.Common Terminology Criteria for Adverse Events (CTCAE). Version 4.0.2009. Retrieved fromhttps:\/\/www.eortc.be\/services\/doc\/ctc(Accessed January 2018)."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00667-4"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2016.09.010"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.147900"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1257795"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-604272"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-621466"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215637"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-635326"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14660"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12355"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-04-1142"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00325.2015"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01806.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.115.306130"},{"issue":"11","key":"e_1_2_9_28_1","first-page":"970","article-title":"Proposed algorithm for managing ibrutinib\u2010related atrial fibrillation","volume":"30","author":"Vrontikis A","year":"2016","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14324"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq278"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12478"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2017.1315115"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.126672"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13651"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2016.1225037"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200342010-00003"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv309"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux240"},{"key":"e_1_2_9_41_1","unstructured":"Imbruvica\u2014summary of product characteristics. Retrieved fromhttp:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR.Product_Information\/human\/003791\/WC500177775.pdf21 October 2014 (Accessed January 2018)."},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-014-4188-9"},{"key":"e_1_2_9_43_1","article-title":"Increased dabigatran plasma concentration during Ibrutinib treatment: a case of cerebral hemorrhage and successful dabigatran reversal by idarucizumab","volume":"26","author":"Quintavalla R","year":"2017","journal-title":"Aging Clin Exp Res"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.115.065623"},{"issue":"7","key":"e_1_2_9_46_1","first-page":"433","article-title":"Concomitant treatment with ibrutinib and amiodarone causing reversible heart failure syndrome","volume":"18","author":"Wasserstrum Y","year":"2016","journal-title":"Isr Med Assoc J"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.therap.2016.10.005"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dmpk.2015.04.001"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200544030-00005"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-764712"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-12-737346"},{"key":"e_1_2_9_52_1","unstructured":"StevensS WollerS ChangES.Anticoagulation management principles. Epocrates by BMJ. Link. Retrieved fromhttps:\/\/online.epocrates.com\/diseases\/121711\/Anticoagulation\u2010management\u2010principles\/Updated 27.10.2017(Accessed January 2018)."}],"container-title":["Hematological Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhon.2503","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hon.2503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T14:00:24Z","timestamp":1694872824000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hon.2503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,7]]},"references-count":51,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1002\/hon.2503"],"URL":"https:\/\/doi.org\/10.1002\/hon.2503","archive":["Portico"],"relation":{},"ISSN":["0278-0232","1099-1069"],"issn-type":[{"value":"0278-0232","type":"print"},{"value":"1099-1069","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,7]]}}}