RESUMEN
BACKGROUND: Imatinib can induce severe hepatotoxicity, in 1-5% of CML patients, many of whom need permanent imatinib discontinuation. DESIGN AND RESULTS: We report 5 CML patients who developed grade 3-4 hepatotoxicity after 2-8 months in imatinib. Different aetiologies of liver damage were ruled out and toxicity recurred in 2 patients with further attempts at low dose imatinib. In all patients prednisone or methylprednisolone at 25- 40 mg/day resolved hepatotoxicity in 3-8 weeks and allowed imatinib to be resumed at full doses. Corticosteroid were tapered off in 3-5 months without hepatotoxicity recurrence. CONCLUSIONS: Corticosteroid may avoid discontinuation for hepatotoxicity of the most effective anti-CML therapy.
Asunto(s)
Corticoesteroides/uso terapéutico , Antineoplásicos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Hepatopatías/tratamiento farmacológico , Hígado/patología , Piperazinas/efectos adversos , Pirimidinas/efectos adversos , Benzamidas , Humanos , Mesilato de Imatinib , Hígado/efectos de los fármacos , Metilprednisolona/uso terapéutico , Prednisona/uso terapéuticoRESUMEN
13-cis retinoic acid + (OH)2 vitamin D3 + low-dose 6-thioguanine and cytarabine were tested in 26 patients with acute myeloid leukemia (AML) and in 4 patients with myelodysplastic syndrome (MDS) (median age 72.5), ineligible for standard chemotherapy. The response rate was 50%, with 27% complete remission. The median survival of the whole group and responders was 7.5 (1-47+) and 16.5 months (3.5-47+), respectively.