Severe Persistent Marrow Aplasia in Chronic Myeloid Leukemia: An Unusual Complication of Imatinib

Madabhavi, Irappa; Modi, Manisha P; Shah, Nupur; Nilkanthe, Ramrao; Trivedi, Manasi

doi:10.1093/ajcp/aqw157.001

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“…The mechanism underlying this myelosuppression is not fully understood. Old age, advanced disease and history of previous treatment with busulfan or intereferon alfa are noted to have increasing risk of myelosuppression [13]. Asian patients are sometimes intolerant to the recommended dose, and TKIs can achieve an effective plasma level at a lower dose [14].…”

Section: Discussionmentioning

confidence: 99%

Imatinib-Induced Bone Marrow Aplasia in Chronic Myelogenous Leukemia

Dogra,

Shelke

2024

Cureus

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Imatinib is a tyrosine kinase inhibitor (TKI) and is a commonly used medication for treatment of chronic myelogenous leukemia (CML). Aplastic anemia is a very uncommon complication of Gleevec, and only a few cases are reported in the literature. We present a case of a 63-year-old Asian female who was initiated on imatinib for treatment of CML with good response in cell counts. Four months after Gleevec initiation, the patient was admitted to the hospital with extreme fatigue and noted to have severe pancytopenia. Patient received multiple blood transfusions. Finally, the patient underwent bone marrow biopsy, which showed concern for aplastic anemia with marked hypocellular bone marrow. Gleevec was held, blood counts were monitored, and supportive care was given. Patient had slow recovery of her blood counts. There remains scarcity of data on this topic and no criteria exist to predict the myelosuppression with TKI therapy. Our case report aims to reemphasize the need for increased research on myelosuppression with TKI therapy.

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Section: Discussionmentioning

confidence: 99%