01 February 2006
Letter to the editor: imatinib mesylate induce severe pancytopenia in patients with chronic myelogenous leukemia treated previously with busulphanCengiz Beyan, Kürşat Kaptan, Ahmet Ifran
Case Rep Clin Pract Rev 2006; 7:4-5 :: ID: 445549
We have read with great interest the case report on
chronic myelogenous leukemia (CML) by Roback
et al published in your journal’s December issue .
The main reason for our interest is that similarly we
also used imatinib mesylate for acute phase development in a patient treated with busulphan for many years and the development of severe pancytopenia in this patient. A 67 years old woman had been admitted with the complaint of fatigue and disturbances in her complete blood count (CBC). The diagnosis of chronic phase CML was made 13 years ago and busulphan treatment was started after diagnosis
which is followed by a two years’ duration of interferon treatment. Busulphan treatment was reinstituted after interferon and after achieving a normal CBC treatment was stopped and the patient had been followed without medication for the last two years. In CBC, white blood cell (WBC) was 24,2 x109/L, hemoglobin was 8,55 g/dl and platelet count was 26,9 x109/L. The diagnosis of acute phase CML was made because the bone marrow was infiltrated with blasts 75% and the presence of t(9;22) in all metaphases of cytogenetic examination and thereafter imatinib mesylate 400 mg daily was instituted. The requirement of erythrocyte suspension and platelet transfusions increased to daily or the day after transfusions after three weeks of therapy and the dosage of imatinib mesylate reduced to 300 mg/day. But, transfusion requirement of the patient did not decreased and we had to stop therapy. The patient remained pancytopenic for six weeks after cessation of therapy and because of the increment in WBC we had reinstituted 400 mg daily imatinib mesylate therapy.
Imatinib mesylate therapy had been stopped and only
supportive care were given because severe pancytopenia
developed after two weeks of therapy and
transfusion requirement heavily increased. Frequent
erythrocyte and platelet transfusions and empirical
antibiotics were applied for the period of four weeks
of severe pancytopenia. Hydroxyurea was given to
patient because of increase in WBC count. The patient
was dead because of uncontrolled infection on
the fifth week of hydroxyurea treatment. Because
of the picture we observed in this patient, likewise
the authors, we also thought that imatinib mesylate
treatment might cause severe bone marrow aplasia
in patients with advanced disease and treated before
1. Robak T, Jamroziak K, Janus A et al. Imatinib mesylate induced severe bone marrow aplasia in a patient with long duration of chronic myelogenous leukemia treated previously with busulphan and
hydroxyurea. Case Rep Clin Pract Rev 2005; 6: 332–6.
21 March 2023 : Case reportKidney Transplantation from a Deceased Donor with COVID-19 Ad26.COV2-S Vaccine-Induced Thrombotic Thrombocy...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938730
21 March 2023 : Case reportClassical Presentation of Disseminated Blastomycosis in a 44-Year-Old Healthy Man 3 Months After Diagnosis ...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938659
22 February 2023 : Case reportA 30-Year-Old Woman with an 8-Week History of Anxiety, Depression, Insomnia, and Mild Cognitive Impairment ...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938732
22 February 2023 : Case reportMultidrug-Resistant Kocuria rosea and Methicillin-Resistant Staphylococcus aureus Co-Infection in a Nigeria...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938761
22 Mar 2023 : Case reportLaparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis and a Double Superior Vena Cava
Am J Case Rep In Press; DOI: 10.12659/AJCR.938774
22 Mar 2023 : Case reportRare Case of Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome with Monoclonal Gammo...
Am J Case Rep In Press; DOI: 10.12659/AJCR.939650
22 Mar 2023 : Case reportOral and Intranasal Ketamine Use in Treatment-Resistant Catatonia: A Clinical Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939530
22 Mar 2023 : Case reportAn Easily Missed But Life-Threatening Diagnosis: A Case Report of Gorlin Syndrome
Am J Case Rep In Press; DOI: 10.12659/AJCR.939117
Most Viewed Current Articles
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347