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First case of immune‐mediated haemolytic anaemia associated to imatinib mesylate
Author(s) -
Zago Novaretti Marcia C.,
Fonseca Guilherme H. H.,
Conchon Mônika,
DorlhiacLlacer Pedro Enrique,
Alencar Fischer Chamone Dalton
Publication year - 2003
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1046/j.0902-4441.2003.00128.x
Subject(s) - imatinib mesylate , medicine , haemolysis , prednisone , mesylate , imatinib , pharmacology , immunology , gastroenterology , immune system , nilotinib , myeloid leukemia , chemistry , organic chemistry
Imatinib mesylate is a specific inhibitor of protein tyrosine kinase activity secondary to bcr‐abl, mostly indicated for the treatment of patients with Philadelphia chromosome positive chronic myeloid leukaemia (CML). Generally, the undesirable effects of imatinib administration observed in clinical trials were of mild‐to‐moderate degree, and no haemolysis has been associated with this drug. We report here a case of immune‐mediated haemolytic anaemia associated to imatinib mesylate successfully treated with prednisone in a patient with CML. Laboratory investigation showed anaemia [haemoglobin (Hb) of 59 g/L], reticulocyte of 61 × 10 9 /L and a positive direct antiglobulin test. Anti‐drug in vitro studies revealed a positive result with gel microcolumn assay by an adsorption mechanism. Seventy‐four days after prednisone therapy, the patient's Hb level was of 110 g/L with negative direct antiglobulin test and drug in vitro studies. This case demonstrated that patients treated with imatinib mesylate can present immune‐mediated haemolysis and adequate management of this event can be done maintaining the drug and associating corticosteroids.