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

Лопина, Наталья Андреевна; Dyagil, Iryna; Hamov, Dmytro; Zhuravlyova, Larysa; Dmytrenko, I. V.; Lopin, D. A.; Igor, Kuznetsov

doi:10.7759/cureus.3136

Cited by 4 publications

(6 citation statements)

References 17 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Цілком очевидно, що на вміст МСМ у плазмі крові впливають і токсичні ефекти медикаментозного лікування, і порушення дезінтоксикаційної функції печінки і видільної системи [3,18,19,26]. Результати досліджень низки авторів свідчать, що збільшення проявів інтоксикаційного синдрому у пацієнтів із ХМЛ, окрім генетичних порушень, впливу іонізуючого опромінен-ня під час обстежень, відіграє певну роль у виникненні резистентності до лікування [5,8,12,29,30,34].…”

Section: матеріали та методиunclassified

Medium-mass Molecules in Plasma of Patients at Different Stages of Chronic Myeloid Leukemia Progression

Ivanna

2022

FMEP

View full text Add to dashboard Cite

Chronic myeloid leukemia (CML) is a clonal tumor disease caused by malignant transformation of hematopoietic stem cells, in which a chimeric BCR-ABL gene is formed as a result of specific translocation of areas between the 9th and 22nd chromosomes. This genetic «defect» ensures the uncontrolled proliferation of myeloid cells. The objective: to analyse the content of medium-mass molecules (MMM) in peripheral venous blood plasma of patients with CML at different stages of the disease and theoretical justification of approaches to the correction of detected changes. Materials and methods. The study enrolled 77 patients with CML, who were divided into three groups according to the stage of disease. The control group included 20 people who were primary donors of the Kyiv City Blood Center. The main parameters characterizing the state of protein and carbohydrate metabolism were analyzed. All patients groups were similar in terms of age, sex, anthropometric parameters, and duration of the disease. All patients during hospitalization were examined by clinical, laboratory, instrumental and special research methods, and if necessary, consulted by specialists. Statistical processing of the results was done by methods of variational statistics, using the Microsoft Excel XP computer program. Results. Today, there are known factors that determine the development of CML, namely: chromosomal abnormalities, ionizing radiation, hematopoietic system diseases, toxic effects of drugs and polluted environment, etc. Changes in the content of MMM in plasma of patients with CML compared to the control group were determined. As the disease progresses, the imbalance of MMM metabolism deepens. The severity of plasma MMM content violations of CML patients is accompanied by endogenous body intoxication, since MMM are universal markers of endogenous metabolic intoxication. Conclusions. Changes in the content of medium-mass molecules in the plasma of patients with chronic myeloid leukemia dictate the need for further in-depth research to determine role in the pathophysiology of the disease for further treatment and reduction of the manifestations of endogenous intoxication. Effective treatment of patients with CML is based on modern diagnostics, timely prescription of drugs and subsequent monitoring of the course of the disease.

show abstract

Section: матеріали та методиunclassified

Medium-mass Molecules in Plasma of Patients at Different Stages of Chronic Myeloid Leukemia Progression

Ivanna

2022

FMEP

View full text Add to dashboard Cite

show abstract

“…According to the Pub Med analyses, there are more than 25 clinical cases of the acute imatinib hepatitis, however, a small number of cases devoted to the monitoring after the acute imatinib hepatotoxicity in patients have been published. There are publications devoted to further therapeutic approaches and their outcomes, but only several are devoted to the switching to the second-line TKI and some to the imatinib therapy restarting [5-17].…”

Section: Reviewmentioning

confidence: 99%

“…The role and safety of second-generation TKIs after the imatinib acute hepatotoxicity was discussed in some cases [16]. Nowadays, only in several described cases, after the imatinib hepatotoxicity, patients were treated with another TKI without the recurrence of liver injury [13-17].…”

Section: Reviewmentioning

confidence: 99%

“…Previously we described a clinical case of the acute toxic imatinib-induced hepatitis in a 56-year-old woman with chronic myeloid leukemia, concomitant sulfa allergy and rheumatoid arthritis occurred in 2017. Hepatotoxicity appeared after three months of imatinib treatment and three days after the increasing of the imatinib dosage from 400 mg per day to 600 mg per day, which is resolved within three months after the imatinib discontinuation and prednisolone administration [17]. In addition, we provided a two-year follow-up in this clinical case.…”

Section: Reviewmentioning

confidence: 99%

“…Every year, authors from different countries publish their experience of treatment of imatinib-induced hepatoxicity; to date, more than 25 clinical cases of imatinib-induced hepatitis have been published. Currently, there are conflicting data in the literature; in some cases, it was possible to resume the imatinib therapy, while in others, hepatotoxicity resumed after imatinib was restarted and it was necessary to replace imatinib with another TKI in a few cases [5-17]. In addition, follow-up of such patients after imatinib-induced hepatitis and the peculiarities of the second-line therapy have not been widely discussed in publications.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Novel Score-based Decision Approach in Chronic Myeloid Leukemia Patients After Acute Toxic Imatinib-induced Liver Injury

Лопина¹,

Dmytrenko²,

Hamov

et al. 2019

Cureus

Self Cite

View full text Add to dashboard Cite

The tyrosine kinase inhibitor (TKI) imatinib in rare cases can cause acute toxic hepatitis, hepatic failure, and death. Currently, the choice of further chronic myeloid leukemia (CML) therapy in patients after acute hepatotoxicity is still a difficult question, which requires a complex individual approach based on the clinical guidelines of adverse event management. Data about the further follow-up strategy approach in patients with CML after acute toxic imatinib-induced liver injury are of concern, and at times controversial. In addition, one of the questions is about the necessity and safety of the imatinib therapy resumption after acute hepatotoxicity. In some publications, imatinib resumption without the recurrence of hepatotoxicity has been discussed; in others, imatinib resumption with the recurrence of imatinib hepatotoxicity has been mentioned. There are a few publications about the experience of administration of the second-line TKIs after acute imatinib hepatotoxicity. There are no clear data on which factors the physician’s decision should be based on in patients with CML after acute toxic imatinib-induced liver injury. Imatinib should be restarted or withdrawn, when and for whom second-line therapy should be started. The physician’s decision is usually based on the published data of similar cases, personal experience, and the severity of hepatotoxicity. We have discussed the clinical guidelines devoted to the peculiarities of the patient’s management after acute toxic imatinib-induced hepatitis and main strategy approaches. A complex score-based decision algorithm for choosing the further strategy approach after acute toxic imatinib-induced hepatitis in patients with CML has been presented. The following parameters should be assessed: the grade of hepatotoxicity reaction, the presence of liver transplantation or imatinib-induced liver cirrhosis and its possible pathogenetic mechanism, the presence of early molecular response (EMR) to imatinib therapy defined as three-month BCR-ABL1 ≤10% according to the international scale ( BCR-ABL1 IS ) or/and six-month BCR-ABL1 IS <1%; and the presence of the offender concomitant drug that probably caused the drug interaction with imatinib and the presence of viral hepatitis reactivation identified by polymerase chain reaction (PCR).

show abstract

The prevalence of hepatic and thyroid toxicity associated with imatinib treatment of chronic myeloid leukaemia: a systematic review

Tobaiqy,

Helmi,

MacLure

et al. 2023

Int J Clin Pharm

View full text Add to dashboard Cite

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

Cited by 4 publications

References 17 publications

Medium-mass Molecules in Plasma of Patients at Different Stages of Chronic Myeloid Leukemia Progression

Medium-mass Molecules in Plasma of Patients at Different Stages of Chronic Myeloid Leukemia Progression

Novel Score-based Decision Approach in Chronic Myeloid Leukemia Patients After Acute Toxic Imatinib-induced Liver Injury

The prevalence of hepatic and thyroid toxicity associated with imatinib treatment of chronic myeloid leukaemia: a systematic review

Contact Info

Product

Resources

About