Imatinib-induced postoperative periorbital purpura: GASP (Gleevec-Associated Surgical Purpura) in a woman with imatinib-treated chronic myelogenous leukemia.
BACKGROUND
Imatinib mesylate is a selective tyrosine kinase inhibitor used in the treatment of chronic myelogenous leukemia. Ocular side effects of imatinib include periorbital edema, which may become so severe as to obstruct the visual field.


OBJECTIVE
The purpose of this case study is to describe the clinical characteristics of imatinib- induced postoperative periorbital purpura.


METHODS
We retrospectively reviewed the medical literature using PubMed, searching the terms edema, Gleevec, imatinib, periorbital, postoperative and purpura. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented.


RESULTS
Three patients have undergone surgery to reduce the imatinib-induced periorbital edema; two of these individuals have developed imatinib-induced postoperative periorbital purpura.


CONCLUSIONS
We recommend discontinuing imatinib usage one week prior to periorbital surgery and not resuming therapy until the eighth postoperative day.
University of Texas Medical School.
C Lane
CL
Anzalone
Philip R
PR
Cohen
Razelle
R
Kurzrock
Jorge E
JE
Cortes
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001549:Benzamides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D019882:Blepharoplasty; D004334:Drug Administration Schedule; D004438:Ecchymosis / Q000139:chemically induced; D004487:Edema / Q000139:chemically induced* / Q000601:surgery; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000601:surgery; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000139:chemically induced*; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D011300:Preoperative Care; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011693:Purpura / Q000139:chemically induced*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D016038:Skin Transplantation
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate