Vol 1, No 3 (2010)
Case report
Published online: 2010-07-27
Imatinib-induced toxic liver failure in patients with chronic myeloid leukemia
Hematologia 2010;1(3):254-260.
Abstract
Imatinib (IM) selectively inhibits the activity of some tyrosine kinases, including BCR-ABL1
and c-KIT. Mainly because of this mode of action, it has been registered as the first line
treatment option for patients with chronic myeloid leukemia (CML) in the chronic, accelerated
and blast crisis phases, patients with inoperable and disseminated gastrointestinal stromal tumors (GIST) and in the other rare malignancies with genetic abnormalities related to
platelet-derived growth receptor, e.g. chronic myeloproliferative neoplasms with t(5;12) or
hypereosinophilic syndrome. Although the treatment is generally well tolerated, about 2–5% of
IM-treated patients may develop toxic liver failure. Herein, we report two clinical cases of
hepatotoxicity induced by IM at the standard dose 400 mg/day. In both cases, cessation of IM
treatment resulted in normalization of liver function, however with concomitant lost of cytogenetic
and hematologic response. Subsequent treatment with the 2nd generation inhibitor of
tyrosine kinase - dasatinib at a dose 100 mg/day allowed to achieve again cytogenetic and
hematologic response without any signs of hepatotoxicity. These cases underscore the potential
IM-induced liver failure and emerge for regular monitoring of liver function throughout the
treatment.
Hematologia 2010; 1, 3: 254-260
Keywords: chronic myeloid leukemiaimatinibdasatinibhepatotoxicity