Fiche publication
Date publication
avril 2016
Journal
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners
Auteurs
Membres identifiés du Cancéropôle Est :
Dr OJEDA-URIBE Mario
,
Dr DEBLIQUIS Agathe
Tous les auteurs :
Ojeda-Uribe M, Merieau S, Guillon M, Aujoulat O, Hinschberger O, Eisenmann JC, Kenizou D, Debliquis A, Veyradier A, Chantrel F
Lien Pubmed
Résumé
Drug-mediated thrombotic microangiopathy may cause life-threatening medical emergencies. Novel targeted therapies have dramatically changed the prognosis of a number of oncological diseases. Tyrosine kinase inhibitors of the Breakpoint Cluster Region-Abelson (BCR-ABL) oncoprotein are used in patients with chronic myeloid leukemia or Philadelphia chromosome-positive acute lymphoblastic leukemia. Imatinib mesylate, which was the first anti-BCR-ABL tyrosine kinase inhibitor, has demonstrated a high tolerance profile and efficacy in these patients for many years. Good results have also been observed in patients with gastrointestinal stromal tumors. In this study, we describe two patients with Philadelphia chromosome-positive hematological malignancies who presented with secondary thrombotic microangiopathy that was most likely linked to the use of imatinib. Other potential causes of thrombotic microangiopathy were discarded, and the predisposing role of some comorbidities and potential short or long-term drug-drug interactions was assessed. The clinical and biological data were more indicative of atypical secondary hemolytic uremic syndrome in one of the cases and of secondary thrombotic microangiopathy with renal and cardiac impairment in the other, which is also categorized as secondary hemolytic uremic syndrome. The outcome was favorable after imatinib discontinuation and the treatment of severe cardiac and renal failures.
Mots clés
Aged, Female, Humans, Imatinib Mesylate, adverse effects, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, diagnosis, Middle Aged, Protein Kinase Inhibitors, adverse effects, Thrombotic Microangiopathies, chemically induced
Référence
J Oncol Pharm Pract. 2016 Apr;22(2):361-70
