Imatinib-induced Severe Hepatitis in a 9-Year-old Girl With Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia.
Imatinib mesylate has dramatically improved the outcome of children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph* ALL) and is now included as first-line therapy. Uncommon adverse effects of this drug for pediatric use, however, are largely unknown. We report the first case of a 9-year-old child who developed severe acute hepatitis with grade 4 transaminases and bilirubin elevation during imatinib treatment for Ph* ALL. Liver biopsy showed extensive lobular and pericentral necrosis of hepatocytes. Liver function recovered after discontinuing imatinib with a 4-week prednisolone. Extensive hepatic necrosis should be considered not only in adults but also in children under imatinib administration.
*Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba Departments of †Child Health ‡Pathology, Faculty of Medicine §Clinical Laboratory, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
Ryoko
R
Suzuki
Chie
C
Kobayashi
Aiko
A
Sakai
Hiroko
H
Fukushima
Manabu
M
Tagawa
Kaishi
K
Satomi
Toru
T
Nanmoku
Ryo
R
Sumazaki
Takashi
T
Fukushima
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides / Q000009:adverse effects*; D002648:Child; D005260:Female; D006505:Hepatitis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D000068877:Imatinib Mesylate; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D011743:Pyrimidines / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011239:Prednisolone