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• W2312488045 abstract "Imatinib mesylate (STI 571) is one of the fundamental chemotherapeutic agents used in the treatment of the chronic, accelerated and blastic phases of chronic myelocytic leukemia (CML), gastrointestinal stromal tumors and Philadelphia chromosome-positive acute lymphoblastic leukemia. It selectively inhibits receptor tyrosine kinases. Its effects limit the use of this drug. We present a case with a serious skin reaction requiring the discontinuation of the drug and that developed in relation to imatinib therapy. Six months prior, a 61-year-old male patient presenting to the hematology polyclinic with complaints of weight loss and sweating was hospitalized due to high leukocyte value. As a result of the hemogram, biochemistry analyses, peripheral blood smear examination, bone marrow aspiration evaluation, cytogenetic examination using FISH and PCR that were performed, CML was diagnosed. Additionally, to exclude myelofibrosis, we examined a bone marrow biopsy. Imatinib mesylate was started at 400 mg/day orally. In the fourth month of treatment, the patient complained of itching and a skin rash. Although the drug dose was reduced (300 mg/day), his complaints gradually increased. The skin biopsy result was superficial perivascular dermatitis. Imatinib was discontinued, and the patient was started on corticosteroid. The lesions disappeared completely. A month later, the patient was restarted on imatinib mesylate. However, the lesions recurred more prominently. His itching increased. The patient was considered intolerant to imatinib mesylate, and a second-generation tyrosine kinase inhibitor, dasatinib 100 mg/day, was started orally. The follow-up and treatment continues for the patient, who has been taking dasatinib 100 mg/day for the last two months without any skin finding or complaints. Imatinib mesylate-induced skin reactions are associated with the pharmacologic effect of the drug rather than hypersensitivity to the drug. Skin reactions are frequently observed, and this side effect is dose dependent. However, the interesting aspect of our case was that despite dose reduction, skin findings gradually increased, and eventually the drug had to be discontinued. İmatinib mesilat (STI 571); kronik miyelositer lösemi (KML)’nin kronik, akselere ve blastik fazı, gastrointestinal stromal tümörler ve philadelphia pozitif akut lenfoblastik lösemi tedavisinde kullanılan temel kemoterapötik ajanlardan biridir. Selektif olarak tirozin reseptör kinazı inhibe eder. Bu ilaca bağlı gelişen yan etkiler ilacın kullanımını sınırlar. Biz imatinib tedavisine bağlı gelişen ve ilacın kesilmesini gerektiren ciddi cilt reaksiyonu olan bir olguyu sunduk. Altı ay önce hematoloji polikliniğine kilo kaybı ve terleme şikayeti ile başvuran 61 yaşındaki erkek hasta lökosit değerinin yüksek olması nedeniyle yatırıldı. Yapılan hemogram, biokimya tetkikleri, periferik kan yaymasının incelenmesi, kemik iliği aspirasyon ve biopsisinin değerlendirilmesi, FİSH ve PCR ile sitogenetik inceleme sonucu KML tanısı konuldu. Aynı zamanda miyelofibrozisi dışlamak için kemik iliği biopsi incelemesi yapıldı. İmatinib mesilat 400 mg/gün oral olarak başlandı. Tedavinin 4. ayında hastada ciltte kaşıntı ve döküntü şikayeti oldu. İlaç dozu azaltılmasına rağmen (300 mg/gün) şikayetleri giderek arttı. Cilt biyopsi sonucu yüzeyel perivasküler dermatit olarak geldi. İmatinib kesildi ve hastaya kortikosteroid başlandı. Lezyonlar tamamen kayboldu. Bir ay sonra hastaya tekrar imatinib mesilat başlandı. Ancak lezyonlar daha belirgin bir şekilde tekrarladı. Kaşıntısı arttı. Bunun üzerine hasta imatinib mesilat adlı ilaca intoleran olarak kabul edildi ve ikinci jenerasyon tirozin kinaz inhibitörü olarak dasatinib 100 mg/gün oral olarak başlandı. Son iki aydır dasatinib 100 mg/gün almakta olan hastanın herhangi bir cilt bulgusu ve şikayeti olmaksızın takip ve tedavisi devam etmektedir. İmatinib mesilata bağlı cilt reaksiyonları ilaca hipersensitiviteden ziyade ilacın farmakolojik etkisi ile ilişkilidir. Cilt reaksiyonları sık olarak gözlenir ve bu durum doz bağımlıdır. Ancak bizim olgumuzun ilginç tarafı doz azaltılmasına rağmen cilt bulgularının giderek artması ve en sonunda da ilacın kesilmek zorunda kalınması idi." @default.
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• W2312488045 date "2011-12-01" @default.
• W2312488045 modified "2023-10-14" @default.
• W2312488045 title "Serious Skin Reaction Associated with Imatinib in a Patient with Chronic Myeloid Leukemia" @default.
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• W2312488045 doi "https://doi.org/10.5152/eajm.2011.42" @default.
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