Kikuchi Satoru, Muroi Kazuo, Takahashi Satoko, Kawano-Yamamoto Chizuru, Takatoku Masaaki, Miyazato Akira, Nagai Tadashi, Mori Masaki, Komatsu Norio, Ozawa Keiya
Division of Hematology, Department of Medicine, Jichi Medical School, Minamikawachi, Japan.
Leuk Lymphoma. 2004 Nov;45(11):2349-51. doi: 10.1080/10428190412331272721.
A 40-year-old female with chronic myelogeneous leukemia (CML) in the chronic phase was treated with imatinib mesylate (STI571) because of interferon resistance. She achieved complete cytogenetic response but not complete molecular response 3 months after STI571 administration. Six months later, she developed severe liver damage without evidence of actively infectious hepatitis A, B, C, G, E, TT virus, Epstein-Barr virus or cytomegalovirus. A significant serum level of STI571 (107 ng/ml) was detected, although she had not taken the drug for 6 days. Liver biopsy demonstrated massive hepatic necrosis, consistent with drug-induced hepatitis. She achieved complete molecular response, although she did not take STI571 for 47 days after the development of hepatitis. These results suggest that both hepatitis and molecular response were associated with the serum STI571 concentration.
一名处于慢性期的40岁慢性粒细胞白血病（CML）女性患者因对干扰素耐药，接受甲磺酸伊马替尼（STI571）治疗。服用STI571 3个月后，她实现了完全细胞遗传学缓解，但未达到完全分子学缓解。6个月后，她出现严重肝损伤，且没有甲型、乙型、丙型、戊型、庚型、TT病毒、EB病毒或巨细胞病毒活动性感染性肝炎的证据。尽管她已经6天未服用该药，但仍检测到显著的血清STI571水平（107 ng/ml）。肝活检显示大量肝坏死，符合药物性肝炎。尽管在肝炎发生后47天她未服用STI571，但她实现了完全分子学缓解。这些结果表明，肝炎和分子学缓解均与血清STI571浓度有关。
