Division of Hematology-Oncology, Department of Internal Medicine, Gyeongnam Regional Cancer Center, Institute of Health Sciences, Gyeongsang National University School of Medicine, 90 Chilam-dong, Jinju, 660-702, Korea.
Int J Hematol. 2013 Sep;98(3):361-5. doi: 10.1007/s12185-013-1398-5. Epub 2013 Jul 23.
Nilotinib is a second-generation tyrosine kinase inhibitor active in patients with chronic myeloid leukemia (CML) resistant to imatinib, and has been recently approved for newly diagnosed patients. We present a case of nilotinib-induced interstitial lung disease (ILD). A 67-year-old female patient was initially treated with imatinib for chronic-phase Philadelphia chromosome-positive (Ph(+)) CML. Imatinib was replaced by nilotinib because of hematological toxicity. The patient had received nilotinib for about 3 years without significant adverse effects. She visited the clinic due to chronic cough; chest X-ray revealed consolidations in both lung fields. Nilotinib-induced ILD was diagnosed based on intensive workup, including lung biopsy. She responded dramatically to corticosteroid therapy. To our knowledge, this is the first reported case of nilotinib-induced ILD in a patient with Ph(+) CML. We emphasize that if unexplained lung abnormalities progress in patients receiving nilotinib, physicians should consider this potentially fatal complication in their differential diagnoses.
尼洛替尼是一种第二代酪氨酸激酶抑制剂，对耐伊马替尼的慢性髓性白血病（CML）患者有效，最近已被批准用于新诊断的患者。我们报告了一例尼洛替尼引起的间质性肺病（ILD）。一名 67 岁女性患者最初接受伊马替尼治疗慢性期费城染色体阳性（Ph(+））CML。由于血液学毒性，伊马替尼被尼洛替尼取代。该患者接受尼洛替尼治疗约 3 年，无明显不良反应。她因慢性咳嗽就诊；胸部 X 线显示双肺实变。根据包括肺活检在内的强化检查，诊断为尼洛替尼诱导的 ILD。她对皮质类固醇治疗反应迅速。据我们所知，这是首例 Ph(+) CML 患者接受尼洛替尼治疗后发生 ILD 的报告。我们强调，如果接受尼洛替尼治疗的患者出现不明原因的肺部异常进展，医生应在鉴别诊断中考虑这种潜在致命的并发症。
