Imatinib-induced fulminant liver failure in chronic myeloid leukemia: role of liver transplant and second-generation tyrosine kinase inhibitors: a case report

Nacif, Lucas Souto; Waisberg, Daniel Reis; Pinheiro, Rafael Soares; Lima, Fábio; Rocha-Santos, Vinícius; Andraus, Wellington; D’Albuquerque, Luiz Carneiro

doi:10.1186/s13256-018-1588-0

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…In a recent case report, Nacif referenced 11 published cases of fulminant liver failure in the literature. 11 In most cases, the onset of detectable liver injury occurred after more than 20 weeks of uninterrupted imatinib treatment, although there was 1 case with an exposure of 2 weeks' duration. We consider it unlikely that a brief exposure to imatinib would have resulted in clinically apparent liver injury several months later.…”

Section: Discussionmentioning

confidence: 96%

A Case of Severe, Nilotinib-Induced Liver Injury

et al. 2019

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Idiosyncratic hepatotoxicity is a leading reason for the discontinuation or dose modification of Food and Drug Administration (FDA)-approved medications in the United States. We report the case of a 53-year-old woman with chronic myeloid leukemia who developed acute cholestatic hepatitis in response to the tyrosine kinase inhibitor nilotinib. Nilotinib was discontinued, and the patient's liver function tests normalized over the next 3 months. We conclude that nilotinib may cause life-threatening hepatotoxicity and recommend that patients on the medication undergo regular monitoring of their liver tests.

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Section: Discussionmentioning

confidence: 96%

A Case of Severe, Nilotinib-Induced Liver Injury

et al. 2019

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“…An analysis of imatinib hepatotoxicity cases in the future can help to identify predisposing factors, define the group of patients for whom imatinib should be avoided, especially women [ 3 , 5 - 9 , 12 - 14 , 16 , 18 ], thereby reducing the number of cases of severe imatinib hepatotoxicity and the high mortality rate associated with it.…”

Section: Discussionmentioning

confidence: 99%

Сase Report of Acute Toxic Imatinib-induced Hepatitis in a Patient with Chronic Myeloid Leukemia, Sulfa Allergy, and Rheumatoid Arthritis

Лопина¹,

Dyagil²,

Hamov³

et al. 2018

Cureus

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The introduction of imatinib has substantially changed the approaches to the therapy of chronic myeloid leukemia. However, this drug can cause hepatic failure and death in rare cases. This report describes a clinical case of acute, toxic imatinib-induced hepatitis in a 56-year-old woman with chronic myeloid leukemia and concomitant sulfa allergy and rheumatoid arthritis. The patient developed acute imatinib-induced hepatitis after three months of treatment with imatinib and three days after increasing the imatinib dosage from 400 mg per day to 600 mg per day, resolving within three months after imatinib discontinuation and prednisolone administration. This confirms the necessity of great caution during imatinib therapy and the monitoring of liver tests. Approximately 25 reports about clinical cases of imatinib-induced hepatitis have been published up to the present.

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“…Imatinib is associated with acute liver failure leading to death or transplantation, but this severe toxicity remains rare. In most cases, toxicity develops 7 to 20 weeks from initiation of therapy but may occur at any interval [ 69 , 70 ]. Risk factors for the development of hepatotoxicity include the presence of viral hepatitis and pretreatment liver impairment.…”

Section: Methodsmentioning

confidence: 99%

A Review of Cancer Immunotherapy Toxicity II: Adoptive Cellular Therapies, Kinase Inhibitors, Monoclonal Antibodies, and Oncolytic Viruses

Chhabra

Kennedy

2021

J. Med. Toxicol.

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Immunotherapy for cancer has undergone a rapid expansion in classes, agents, and indications. By utilizing aspects of the body’s innate immune system, immunotherapy has improved life expectancy and quality of life for patients with several types of cancer. Adoptive cellular therapies, including chimeric antigen receptor T (CAR T) cell therapy, involve the genetic engineering of patient T cells to allow for targeting of neoplastic cells. Monitoring of patients during the lymphodepletion prior to therapy and following CAR T cell infusion is necessary to detect toxicity of therapy. Specific toxicities include cytokine release syndrome and neurologic toxicity, both of which may be life-threatening. Tocilizumab and/or corticosteroids should be considered for moderate to severe toxicity. Kinase inhibitor toxicity can occur as “on target” effects or “off target” effects to multiple organ systems due to shared protein epitopes. Treatments are organ-specific. Infusion reactions are common during treatment with monoclonal antibodies and treatment is largely supportive. Clinical experience with oncolytic viruses is limited, but local reactions including cellulitis as well as systemic influenza-like syndromes have been seen but are typically mild. Although clinical experience with adverse effects due to newer immunotherapy agents is growing, an up-to-date understanding of their mechanisms and potential toxicities is critical.

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Imatinib-induced fulminant liver failure in chronic myeloid leukemia: role of liver transplant and second-generation tyrosine kinase inhibitors: a case report

Cited by 13 publications

References 11 publications

A Case of Severe, Nilotinib-Induced Liver Injury

A Case of Severe, Nilotinib-Induced Liver Injury

Сase Report of Acute Toxic Imatinib-induced Hepatitis in a Patient with Chronic Myeloid Leukemia, Sulfa Allergy, and Rheumatoid Arthritis

A Review of Cancer Immunotherapy Toxicity II: Adoptive Cellular Therapies, Kinase Inhibitors, Monoclonal Antibodies, and Oncolytic Viruses

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