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Pleural effusion in CML on imatinib

  • Dr. Saurabh Bhave
  • Dr. Saurabh Bhave's Avatar Topic Author
5 years 7 months ago #1710 by Dr. Saurabh Bhave
Pleural effusion in CML on imatinib was created by Dr. Saurabh Bhave
We have a middle aged lady with CML. started on imatinib 400 mg OD since
2 months after starting she had left pleural effusion which required tapping.The examination of the fluid revealed no significant finding. She continued on imatinib and was doing well. She has not achieved MMR at the end of 1 year of treatment.
Recently again she develpoed massive pleural effusion which required tapping.
Repeat examination of the fluid revealed no abnormal finding

1.Dose Imatinib cause pleural effusion: There are some case reports

2.Shall we stop imatinib

Regards

Dr.Saurabh Bhave
M.D. PDF Clinical Haematology
Consultant, Hematology and Bone Marrow Transplant
Tata Medical Center, Kolkata
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  • Hemant Malhotra
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5 years 7 months ago #1711 by Hemant Malhotra
Replied by Hemant Malhotra on topic Pleural effusion in CML on imatinib
Dear Dr. Saurabh,
Thank you for posting this interesting case.
I would suggest that you look for some other cause of the effusion.
Pleural effusions can happen with imatinib (must less common when compared with dasatinib) but are quite rare - occurs in approximately 2% of patients.
Please rule out tuberculosis (not uncommon in India) and collagen vascular disease/connective tissue disorders with appropriate tests.
With regards to Imatinib, as the patient has not achieved a MMR even at 12 months, she should be switched to a second gen, TKI, and with the recurrent effusions, Nilotinib would be the obvious choice.
Hope your patient does well.
Best wishes.
Dr. Hemant Malhotra,

ORIGINAL CASE:
We have a middle aged lady with CML. started on imatinib 400 mg OD since
2 months after starting she had left pleural effusion which required tapping.The examination of the fluid revealed no significant finding. She continued on imatinib and was doing well. She has not achieved MMR at the end of 1 year of treatment.
Recently again she develpoed massive pleural effusion which required tapping.
Repeat examination of the fluid revealed no abnormal finding

1.Dose Imatinib cause pleural effusion: There are some case reports

2.Shall we stop imatinib
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