“…The antiplatelet effect of ibrutinib appears to vary among patients, but is exacerbated by other medications (particularly aspirin, clopidogrel, non-steroidal anti-inflammatory drugs) and dietary supplements that affect platelet function. However, routine platelet function studies in CLL patients may be confounded by thrombocytopenia and acquired platelet function defects reported in some CLL patients prior to the commencement of ibrutinib (Levade et al, 2014;Lipsky et al, 2015Lipsky et al, , 2016Tam & Kamel, 2016). These acquired defects are consistent with an on-target inhibition of BTK signalling downstream from both the platelet collagen receptor glycoprotein (GP)VI, and the von Willebrand factor receptor, GPIb-V-IX (Quek et al, 1998;Bye et al, 2015;Rigg et al, 2016).…”