Corticosteroids can reverse severe imatinib-induced hepatotoxicity.
BACKGROUND
Imatinib can induce severe hepatotoxicity, in 1-5% of CML patients, many of whom need permanent imatinib discontinuation.


RESULTS
We report 5 CML patients who developed grade 3-4 hepatotoxicity after 2-8 months in imatinib. Different aetiologies of liver damage were ruled out and toxicity recurred in 2 patients with further attempts at low dose imatinib. In all patients prednisone or methylprednisolone at 25- 40 mg/day resolved hepatotoxicity in 3-8 weeks and allowed imatinib to be resumed at full doses. Corticosteroid were tapered off in 3-5 months without hepatotoxicity recurrence.


CONCLUSIONS
Corticosteroid may avoid discontinuation for hepatotoxicity of the most effective anti-CML therapy.
Ferrero
Dario
D
Divisione di Ematologia dell'Università degli Studi di Torino, Molinette Hospital, Turin, Italy. daferrero@yahoo.com
Pogliani
Enrico Maria
EM
Rege-Cambrin
Giovanna
G
Fava
Carmen
C
Mattioli
Giovanna
G
Dellacasa
Chiara
C
Campa
Elisabetta
E
Perfetti
Paola
P
Fumagalli
Monica
M
Boccadoro
Mario
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides; D056486:Chemical and Drug Induced Liver Injury; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008099:Liver / Q000187:drug effects / Q000473:pathology*; D008107:Liver Diseases / Q000188:drug therapy*; D008775:Methylprednisolone / Q000627:therapeutic use; D010879:Piperazines / Q000009:adverse effects*; D011241:Prednisone / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects*
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011241:Prednisone; D008775:Methylprednisolone