Vol 3, No 3 (2012)
Case report
Published online: 2012-10-11

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Successful therapy with dasatinib in patient with recurrent liver toxicity associated with imatinib and nilotinib administration

Tomasz Sacha
Hematologia 2012;3(3):267-270.

Abstract

Imatinib, dasatinib and nilotinib have different activity against tyrosine kinases. It determines
a different toxicity profile of those inhibitors. The case of patient with chronic myeloid leukemia
in chronic phase treated initially with imatinib is described. The patient achieved major
molecular response, but the therapy was interrupted for three months due to 3. grade liver
toxicity. After the symptoms have been resolved dasatinib was introduced. The patient were
suffering however from severe vertebral spine, muscle and bone pains and malaise and refused
further treatment with dasatinib. After one month of nilotinib administration symptoms of
liver toxicity reoccurred with the same intensity as during therapy with imatinib. Nilotinib was discontinued. After the symptoms have been resolved dasatinib was reintroduced without
intolerance signs observed before. Due to a thrombocytopenia the dosage of dasatinib was
reduced. Liver toxicity signs did not reoccur during further dasatinib therapy which resulted
in complete molecular response.

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Hematology in Clinical Practice