title: Imatinib-induced liver cirrhosis in a patient with advanced gastrointestinal stroma tumor (GIST).
abstract: BACKGROUND
  The use of imatinib mesylate is associated with a progression free survival of 41 months in first line treatment of metastatic or locally advanced gastrointestinal stromal tumors (GIST) and other studies approved that adjuvant imatinib treatment improves the recurrence-free survival in patients with GIST. Current recommendations include 1 year adjuvant treatment in GIST patients at risk but active studies explore different durations of treatment with an interval of up to 5 years. While the most frequent adverse events (AEs) are blood count alterations, abdominal discomfort and edema, the occurrence of grade 3 or 4 increase of AST or ALT is specified with 2.1% and 2.7% respectively.
  
  
  METHODS
  We report a 49-year old male with a gastrointestinal stromal tumor (GIST) of the small bowel who developed liver cirrhosis under adjuvant imatinib treatment.
  
  
  CONCLUSIONS
  Our report supports the notion that imatinib-induced hepatotoxicity may lead to acute liver damage with subsequent cirrhotic remodelling. Patients developing grade 3 or 4 hepatotoxicity during imatinib treatment should therefore be carefully evaluated for chronic liver disease.
authors.affiliation: Department of Hematology, Hemostasis, Oncology and Stem cell transplantation, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany. seidel.christoph@mh-hannover.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Seidel
authors.forename: Martin
authors.initials: M
authors.lastname: Fenner
authors.forename: Florian
authors.initials: F
authors.lastname: Länger
authors.forename: Heike
authors.initials: H
authors.lastname: Bantel
authors.forename: Arnold
authors.initials: A
authors.lastname: Ganser
authors.forename: Viktor
authors.initials: V
authors.lastname: Grünwald
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001549:Benzamides; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D000068877:Imatinib Mesylate; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate