Non-Hodgkin's lymphoma developed during imatinib mesylate treatment of chronic myeloid leukemia

J Oncol Pharm Pract. 2023 Jun;29(4):996-998. doi: 10.1177/10781552221137700. Epub 2022 Nov 7.

Abstract

Introduction: Non-Hodgkin lymphoma induced by imatinib, as a tyrosine kinase inhibitor, is a rare complication.

Case report: A 54-year-old female with a history of chronic myeloid leukemia (CML) was treated with imatinib as first-line therapy. The patient achieved a profound molecular response with treatment-free remission after five years but lost major molecular responses. A second deep molecular remission was again achieved. Nine years after imatinib therapy, the patient developed odynophagia and rhinorrhea. Physical examination revealed enlarged tonsils with a tumor-like appearance without palpable lymph nodes. Immunohistochemical examination of the tonsils revealed a large B-cell lymphoma. According to Naranjo's algorithm, the causality relationship with the drug is possible with a score of 3.

Management and outcome: Imatinib was discontinued. The lymphoma was treated with rituximab and chemotherapy.

Discussion: Non-Hodgkin's lymphoma is a rare side effect of tyrosine kinase inhibitors and highlights the importance of follow-up CML patients.

Keywords: Imatinib; chronic myeloid leukemia; lymphoma; secondary malignancies.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Female
  • Humans
  • Imatinib Mesylate / adverse effects
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Lymphoma, Non-Hodgkin* / complications
  • Lymphoma, Non-Hodgkin* / drug therapy
  • Middle Aged
  • Protein Kinase Inhibitors / adverse effects
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • Imatinib Mesylate
  • Protein Kinase Inhibitors
  • Rituximab
  • Antineoplastic Agents