Imatinib-induced fulminant liver failure in chronic myeloid leukemia: role of liver transplant and second-generation tyrosine kinase inhibitors: a case report

J Med Case Rep. 2018 Mar 10;12(1):63. doi: 10.1186/s13256-018-1588-0.

Abstract

Background: There is a worldwide problem of acute liver failure and mortality associated with remaining on the waiting for a liver transplant. In this study, we highlight results published in recent years by leading transplant centers in evaluating imatinib-induced acute liver failure in chronic myeloid leukemia and follow-up in liver transplantation.

Case presentation: A 36-year-old brown-skinned woman (mixed Brazilian race) diagnosed 1 year earlier with chronic myeloid leukemia was started after delivery of a baby and continued for 6 months with imatinib mesylate (selective inhibitor of Bcr-Abl tyrosine kinase), which induced liver failure. We conducted a literature review using the PubMed database for articles published through September 2017, and we demonstrate a role of liver transplant in this situation for imatinib-induced liver failure. We report previously published results and a successful liver transplant after acute liver failure due to imatinib-induced in chronic myeloid leukemia treatment.

Conclusions: We report a case of a successful liver transplant after acute liver failure resulting from imatinib-induced chronic myeloid leukemia treatment. The literature reveals the importance of prompt acute liver failure diagnosis and treatment with liver transplant in selected cases.

Keywords: Acute liver failure; Liver transplantation; Organ graft; Transplantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain
  • Adult
  • Chemical and Drug Induced Liver Injury / physiopathology
  • Chemical and Drug Induced Liver Injury / surgery*
  • Female
  • Humans
  • Imatinib Mesylate / adverse effects*
  • Imatinib Mesylate / therapeutic use
  • Immunosuppression Therapy / methods
  • Jaundice
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / physiopathology
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / physiopathology
  • Liver Failure, Acute / surgery
  • Liver Transplantation*
  • Nausea
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Protein Kinase Inhibitors
  • Imatinib Mesylate