Imatinib Induced Delayed and Refractory Generalized Fluid Retention: A Case Report and Review of Literature
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 1
Abstract
Imatinib is a tyrosine kinase inhibitor used mainly for ABL-BCR positive CML. Development of fluid retention(FR) following imatinib therapy is the most common side effect. However, sever FR as generalized anasarca, pleural effusion, ascites, and pericardial effusion are not common events during imatinib treatment. We report a case of CML treated with imatinib for long time then presented with sever generalized FR. After exclusion of other causes of generalized FR we stop imatinib but there was no improvement of the conditions. So, mild FR resulted from imatinib may pass to chronic state and become refractory to treatment and should be treated as early as possible. The molecular targeted therapy started with introduction of tyrosine kinase inhibitor (Imatinib) that selectively inhibit phosphorylation of BCR-ABL protein with subsequent inhibition of growth of BCR-ABL positive cells [1]. Imatinib was approved in 2001 as a first targeted therapy for treatment of BCR-ABL positive chronic myeloid leukemia (CML) and in 2003 for treatment of ckit or CD 117 positive gastrointestinal stromal tumor (GIST) [2,3]. The safety and efficacy profiles of imatinib were explored in the last decades and have been well known, the most common reported side effect and dose limiting toxicity of imatinib was fluid retention (FR) [4]. Manifestations of FR usually presented as mild periorbital and/or lower limbs (LLs) edema that was easily manageable [5]. Development of sever FR manifested by marked subcutaneous and LLs edema, ascites, pleural and pericardial effusions were less frequently seen with imatinib treatment [6]. Due to rarity of imatinib induced sever FR, we reported this case of imatinib induced marked FR presented after long time of imatinib treatment and was refractory to drug withdrawal and conventional treatment.
Authors and Affiliations
Bader A Abdelmaksoud, Yaser Gad, Fayez G Alruwaily
Keywords
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- EP ID EP622731
- DOI 10.26717/BJSTR.2019.19.003233
- Views 141
- Downloads 0
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