Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

01 February 2006

Letter to the editor: imatinib mesylate induce severe pancytopenia in patients with chronic myelogenous leukemia treated previously with busulphan

Cengiz Beyan, Kürşat Kaptan, Ahmet Ifran

Case Rep Clin Pract Rev 2006; 7:4-5 :: ID: 445549

Abstract

DEAR EDITOR,
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 [1].
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
with busulphan.
REFERENCES:
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.

Keywords: Leukemia

Add Comment 0 Comments

0

In Press

12 Feb 2024 : Case report  Germany

Diagnostic Challenges and Imaging Considerations for Intraparotid Facial Nerve Schwannoma: A Case Report an...

Am J Case Rep In Press; DOI: 10.12659/AJCR.942870  

0:00

12 Feb 2024 : Case report  USA

Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PET

Am J Case Rep In Press; DOI: 10.12659/AJCR.941169  

0:00

12 Feb 2024 : Case report  USA

Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.942839  

13 Feb 2024 : Case report  Bahrain

Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel Hematoma

Am J Case Rep In Press; DOI: 10.12659/AJCR.943519  

Most Viewed Current Articles

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

05 Mar 2022 : Case report  Brazil

Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...

DOI :10.12659/AJCR.935336

Am J Case Rep 2022; 23:e935336

02 Apr 2022 : Case report  Saudi Arabia

Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...

DOI :10.12659/AJCR.935743

Am J Case Rep 2022; 23:e935743

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923