Ibrutinib-Associated Nail Plate Abnormalities: Case Reports and Review

Chronic lymphocytic leukemia is a lymphoproliferative disorder characterized by a gradual accumulation of neoplastic B-lymphocytes. Ibrutinib is a novel therapy for chronic lymphocytic leukemia. Ibrutinib therapy has been associated with nail plate abnormalities. Other common cutaneous adverse events caused by ibrutinib appear to be bruising, hair changes, pruritus, and rashes. We describe the clinical features of two patients with chronic lymphocytic leukemia: a 79-year-old woman and a 53-year-old man who developed nail plate abnormalities approximately 6 and 4 months, respectively, after beginning ibrutinib therapy. We also review the characteristics of other patients with chronic lymphocytic leukemia with ibrutinib-associated nail plate abnormalities. The PubMed database was used to search the following terms: abnormal, abnormalities, adverse, brittle, chronic, cutaneous, dystrophy, events, effects, ibrutinib, lymphocytic, leukemia, nail, plate, and side. The relevant referenced papers generated by the search were reviewed. In conclusion, ibrutinib is used to treat chronic lymphocytic leukemia. It is usually well-tolerated. Many patients receiving ibrutinib will develop nail plate abnormalities. This adverse event is not a drug-limiting toxicity.