Recurrent imatinib-induced hepatotoxicity in a chronic myeloid leukaemia patient successfully managed with prednisone.
Imatinib, the frontline tyrosine kinase inhibitor (TKI), has revolutionised the management of chronic myeloid leukaemia (CML). Severe hepatotoxicity, although uncommon, can occur with this drug. This tends to subside with dose reduction or cessation, but can recur with reintroduction of the drug. Recurrent severe hepatotoxicity mandates permanent discontinuation of imatinib. This can cause difficulties in the management of CML, more so if the patient cannot afford or get access to alternate therapy. Furthermore, alternate therapy, for example, second-line TKIs, can impose a huge economic burden on a healthcare system. Here, the authors report the case of 20-year-old CML patient who developed recurrent hepatotoxicity with the use of imatinib. Introduction of corticosteroids enabled successful reintroduction of imatinib therapy.
Division of Hematology and Oncology, Department of Medicine, Sanford R Nalitt Institute for Cancer and Blood Related Diseases, Staten Island University Hospital, Staten Island, New York, USA.
Shilpi
S
Gupta
Vijaya Raj
VR
Bhatt
Seema
S
Varma
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001549:Benzamides; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D055815:Young Adult
D000970:Antineoplastic Agents; D001549:Benzamides; D005938:Glucocorticoids; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011241:Prednisone