Imatinib-induced Fulminant Liver Failure in Chronic Myeloid Leukemia: Role of Liver Transplant and Second-generation Tyrosine Kinase Inhibitors

A Case Report

Lucas Souto Nacif; Daniel R. Waisberg; Rafael Soares Pinheiro; Fabiana Roberto Lima; Vinicius Rocha-Santos; Wellington Andraus; Luiz Carneiro D'Albuquerque


J Med Case Reports. 2018;12(53) 

In This Article

Abstract and Introduction


Background There is a worldwide problem of acute liver failure and mortality associated with remaining on the waiting for a liver transplant. In this study, we highlight results published in recent years by leading transplant centers in evaluating imatinib-induced acute liver failure in chronic myeloid leukemia and follow-up in liver transplantation.

Case presentation A 36-year-old brown-skinned woman (mixed Brazilian race) diagnosed 1 year earlier with chronic myeloid leukemia was started after delivery of a baby and continued for 6 months with imatinib mesylate (selective inhibitor of Bcr-Abl tyrosine kinase), which induced liver failure. We conducted a literature review using the PubMed database for articles published through September 2017, and we demonstrate a role of liver transplant in this situation for imatinib-induced liver failure. We report previously published results and a successful liver transplant after acute liver failure due to imatinib-induced in chronic myeloid leukemia treatment.

Conclusions We report a case of a successful liver transplant after acute liver failure resulting from imatinib-induced chronic myeloid leukemia treatment. The literature reveals the importance of prompt acute liver failure diagnosis and treatment with liver transplant in selected cases.