Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida, USA.
BMJ Case Rep. 2020 Dec 13;13(12):e237069. doi: 10.1136/bcr-2020-237069.
Imatinib is used to treat several haematological and solid malignancies. Cutaneous side effects could often limit the use of this medication. We present a case of a 62-year-old woman with a history of a gastrointestinal stromal tumour that developed a delayed cutaneous adverse reaction 10 days after starting imatinib 400 mg daily. She developed the same symptoms with reintroduction at a dose of 100 mg and with an alternative tyrosine kinase inhibitor, nilotinib 50 mg/day. Given that imatinib was considered her best treatment, she underwent a long induction of drug tolerance (IDT) protocol to imatinib. Patient tolerated the medication without further reactions for 6 months and had improvement of her cancer per last imaging studies. IDT should be considered in delayed hypersensitivity reactions to imatinib after a failed reintroduction of the drug or when no other equally effective agents are available.
伊马替尼用于治疗多种血液系统恶性肿瘤和实体瘤。皮肤副作用往往会限制这种药物的使用。我们报告了一例 62 岁女性，患有胃肠道间质瘤，在开始每日服用 400mg 伊马替尼 10 天后出现迟发性皮肤不良反应。当她以 100mg 剂量重新使用伊马替尼或改用另一种酪氨酸激酶抑制剂尼洛替尼（50mg/天）时，出现了相同的症状。由于伊马替尼被认为是她的最佳治疗方法，她接受了伊马替尼的长期诱导药物耐受（IDT）方案。患者在没有进一步反应的情况下耐受该药物治疗 6 个月，并且最后影像学研究显示癌症有所改善。如果药物重新引入失败或没有其他同样有效的药物时，对于伊马替尼的迟发性过敏反应，应考虑 IDT。
