DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20162491

A rare case of imatinib mesylate induced acute kidney injury

Ratna Agrawal, Kaustav Saha, Sabita Mohapatra

Abstract


Imatinib is a revolutionary targeted molecule strikingly successful in chronic phase of chronic myeloid leukemia and higher doses are beneficial in the accelerated phase of the disease. It’s known adverse effects include abdominal pain, vomiting, fluid retention, periorbital edema, pleural effusion, myalgia, liver damage and congestive heart failure. Renal damage due to this drug has not been well reported. In this case, the patient developed acute kidney injury as evidenced by raised creatinine level after two months of administration of imatinib mesylate. At 4th visit, the levels of urea and creatinine were significantly above the upper normal limit. The patient was kept under supervision of his renal status and at the starting of 5th visit decision was made to change the drug from imatinib to nilotinib. Currently the patient is tolerating nilotinib well. Causality assessment using WHO scale revealed imatinib to have possibly caused this rare adverse reaction.


Keywords


Chronic myeloid leukemia, Imatinib, Renal failure, Creatinine

Full Text:

PDF

References


Chu E, Alan C. Cancer chemotherapy. In: Katzung BG, Trevor AJ, editor. Basic and clinical pharmacology. 13th ed. New Delhi: McGraw-Hill; 2015:936-7.

Tong WG, Kantarjian H, O'Brien S, Faderl S, Ravandi F, Borthakur G, et al. Imatinib front-line therapy is safe and effective in patients with chronic myelogenous leukemia with pre-existing liver and/or renal dysfunction. Cancer. 2010;116:3152-9.

Francois H, Coppo P, Hayman JP, Fouqueray B, Mougenot B, Ronco P, et al. Partial fanconi syndrome induced by imatinib therapy: a novel cause of urinary phosphate. Am J Kidney Dis. 2008;51:298-301.

Kitiyakara C, Atichartakarn V. Renal failure associated with a specific inhibitor of BCR-ABL tyrosine kinase, STI571. Nephrol Dial Transplant. 2002;17(4):685-7.

Gibbons J, Egorin ML, Ramanathan RK, Fu P, Mulkerin DL, Shibata S, et al. Phase I and pharmacokinetic study of imatinib mesylate in patients with advanced malignancies and varying degrees of renal dysfunction: a study by the national cancer institute organ dysfunction working group. J Clin Oncol. 2008;26:570-6.