Imatinib-induced agranulocytosis in patients with gastrointestinal stromal tumors

Agranulocytosis is a rare but serious side effect of imatinib in gastrointestinal stromal tumor (GIST) patients. Imatinib is an inhibitor of the proto‐oncogene tyrosine kinase (c‐kit) and the first‐line agent in patients with locally advanced and metastatic GIST. Little evidence is available on the...

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Bibliographic Details
Published in:Journal of clinical pharmacology 2015-08, Vol.55 (8), p.920-925
Main Authors: Farag, Sheima, Verschoor, Arjan J., Bosma, Jacob W., Gelderblom, Hans, Kerst, J. Martijn, Sleijfer, Stefan, Steeghs, Neeltje
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Adult
Aged, 80 and over
agranulocytosis
Antineoplastic Agents - adverse effects
Female
gastrointestinal stromal tumor
Gastrointestinal Stromal Tumors - drug therapy
Gastrointestinal Stromal Tumors - immunology
GIST
Gleevec
Glivec
Granulocyte Colony-Stimulating Factor - therapeutic use
Humans
imatinib mesylate
Imatinib Mesylate - adverse effects
Leukemia
Leukocyte Count
Male
Middle Aged
neutropenia
Neutropenia - chemically induced
Neutropenia - drug therapy
Side effects
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Summary:Agranulocytosis is a rare but serious side effect of imatinib in gastrointestinal stromal tumor (GIST) patients. Imatinib is an inhibitor of the proto‐oncogene tyrosine kinase (c‐kit) and the first‐line agent in patients with locally advanced and metastatic GIST. Little evidence is available on the management of this adverse event, and consensus‐based guidelines are lacking. In this article, we describe 4 patients with agranulocytosis after starting imatinib. In addition, an overview of the available literature concerning the underlying mechanisms is given, and therapeutic strategies for overcoming this adverse event are discussed. In our experience it appears safe to restart imatinib after normalization of neutrophil count. In case of relapse of agranulocytosis, reintroduction combined with prednisolone, with treatment with granulocyte colony‐stimulating factor or dose reduction can be considered.
ISSN:0091-2700
1552-4604
DOI:10.1002/jcph.498