Tuberculosis complicating imatinib treatment for chronic myeloid leukaemia

Abstract

Although imatinib is not considered a predisposing factor for tuberculosis (TB), the present case report describes three patients in whom imatinib treatment for chronic myeloid leukaemia was complicated by TB. This raises the question of whether imatinib increases susceptibility to TB.There are several reports suggesting that imatinib might impair the immune system, leading to a variety of infections, including varicella zoster and hepatitis B. Control of TB in healthy individuals is achieved through acquired immunity, in which antigen-specific T-cells and macrophages arrest growth of Mycobacterium tuberculosis bacilli and maintain control over persistent bacilli. In the chronic stage of the infection, CD8+ T-cells assist macrophages in controlling intracellular mycobacteria. The T-cell receptor orchestrates this process.The fact that tyrosine kinases play an important role in T-cell receptor signal transduction and that imatinib has been shown to affect T-cell receptor signal transduction, presents a mechanism by which imatinib might impair control of Mycobacterium tuberculosis; thereby leaving the host susceptible to reactivation of tuberculosis.

Chronic myeloid leukemia patient manifesting fatal hepatitis B virus reactivation during treatment with imatinib rescued by liver transplantation: case report and literature review

“…However, it is still unclear whether tyrosine kinase inhibitor (TKI) induces the reactivation of HBV in patients with a latent HBV infection. Recent studies have shown that imatinib mesylate (imatinib), the first molecule of TKI in chronic myeloid leukemia (CML), can impair the immune response [3,4]. HBV reactivation can be possibly occurred in Hepatitis B s antigen (HBs Ag)-positive CML patients during taking imatinib.…”

Sorafenib-Induced Tuberculosis Reactivation

“…The largest body of knowledgerelatestorituximabinthetreatmentoflymphomawhich hasbeenassociatedwithhepatitisBvirus [16]andcytomegalovirus reactivation [17]. TB reactivation has recently been reportedduringtemsirolimustreatmentforrenalcancer [18] and imatinib treatment for chronic myeloid leukaemia [19,20].Tothebestofourknowledge,thisisthefirstreportofTB reactivationfollowingtreatmentwithsorafenib.…”

Reactivation of tuberculosis during temsirolimus therapy

“…Indeed, immune suppression induced by malignancy itself or by prolonged anticancer chemotherapy (including corticosteroids) increases vulnerability to reactivation of tuberculosis, especially in cancer patients with past history of healed tuberculosis [1,2]. However, reactivation of tuberculosis is uncommon in patients receiving short-term treatment [2], and scarcely documented in patients receiving molecular targeted therapies [3]. We report on a patient who developed tuberculosis during treatment with temsirolimus, a finding that has not been reported to date.…”