Kassem Nancy, Ismail Omar M, Elomri Halima, Yassin Mohamad A
Department of Pharmacy, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Department of Hematology and Bone Marrow Transplantation (BMT), National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Am J Case Rep. 2017 Jul 14;18:794-798. doi: 10.12659/ajcr.903485.
BACKGROUND Tyrosine kinase inhibitors (TKIs) are currently an important targeted drug class in the treatment of chronic myeloid leukemia (CML). Imatinib was the first approved TKI for CML in 2001. Nilotinib is a second-generation TKI, approved in 2007; it inhibits BCR-ABL, PDGFR, and c-KIT, and is 30 times more potent than imatinib. Tyrosine kinase enzymes are expressed in multiple tissues and are involved in several signaling pathways; they have been shown to have several off-target side effects. CASE REPORT We report a case of an elderly male with CML and no history of gastrointestinal diseases, treated with nilotinib, and developed recurrent gastric polyps after three years of treatment. We excluded common causes of gastric polyps and therefore considered nilotinib as a probable cause of recurrent gastric polyps. CONCLUSIONS Recurrent gastric polyps could be a potential side effect of nilotinib treatment. Careful long-term monitoring of patients on TKI therapy is necessary and further long-term studies of TKI side effects are needed.
背景 酪氨酸激酶抑制剂(TKIs)是目前治疗慢性髓性白血病(CML)的一类重要靶向药物。伊马替尼是2001年首个被批准用于治疗CML的TKI。尼洛替尼是第二代TKI,于2007年获批;它可抑制BCR-ABL、PDGFR和c-KIT,其效力比伊马替尼强30倍。酪氨酸激酶在多种组织中表达,并参与多种信号通路;已显示它们具有多种脱靶副作用。病例报告 我们报告一例老年男性CML患者,无胃肠道疾病史,接受尼洛替尼治疗,治疗三年后出现复发性胃息肉。我们排除了胃息肉的常见病因,因此认为尼洛替尼可能是复发性胃息肉的病因。结论 复发性胃息肉可能是尼洛替尼治疗的潜在副作用。对接受TKI治疗的患者进行仔细的长期监测是必要的,并且需要对TKI的副作用进行进一步的长期研究。