伊马替尼诱发一名9岁费城染色体阳性急性淋巴细胞白血病女孩发生严重肝炎。
Imatinib-induced Severe Hepatitis in a 9-Year-old Girl With Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia.
作者信息
Suzuki Ryoko, Kobayashi Chie, Sakai Aiko, Fukushima Hiroko, Tagawa Manabu, Satomi Kaishi, Nanmoku Toru, Sumazaki Ryo, Fukushima Takashi
机构信息
*Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba Departments of †Child Health ‡Pathology, Faculty of Medicine §Clinical Laboratory, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
出版信息
J Pediatr Hematol Oncol. 2015 Aug;37(6):e368-71. doi: 10.1097/MPH.0000000000000337.
Imatinib mesylate has dramatically improved the outcome of children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph* ALL) and is now included as first-line therapy. Uncommon adverse effects of this drug for pediatric use, however, are largely unknown. We report the first case of a 9-year-old child who developed severe acute hepatitis with grade 4 transaminases and bilirubin elevation during imatinib treatment for Ph* ALL. Liver biopsy showed extensive lobular and pericentral necrosis of hepatocytes. Liver function recovered after discontinuing imatinib with a 4-week prednisolone. Extensive hepatic necrosis should be considered not only in adults but also in children under imatinib administration.
甲磺酸伊马替尼显著改善了费城染色体阳性急性淋巴细胞白血病（Ph+ ALL）患儿的治疗结果，现已被纳入一线治疗方案。然而，这种药物在儿科使用中罕见的不良反应在很大程度上尚不清楚。我们报告了首例9岁儿童，该患儿在接受甲磺酸伊马替尼治疗Ph+ ALL期间出现严重急性肝炎，转氨酶和胆红素升高至4级。肝活检显示肝细胞广泛的小叶和中央周围坏死。停用甲磺酸伊马替尼并使用泼尼松龙治疗4周后肝功能恢复。不仅在成人中，而且在接受甲磺酸伊马替尼治疗的儿童中，都应考虑广泛的肝坏死。
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