Nilotinib-induced interstitial lung disease

Int J Hematol. 2013 Sep;98(3):361-5. doi: 10.1007/s12185-013-1398-5. Epub 2013 Jul 23.

Abstract

Nilotinib is a second-generation tyrosine kinase inhibitor active in patients with chronic myeloid leukemia (CML) resistant to imatinib, and has been recently approved for newly diagnosed patients. We present a case of nilotinib-induced interstitial lung disease (ILD). A 67-year-old female patient was initially treated with imatinib for chronic-phase Philadelphia chromosome-positive (Ph(+)) CML. Imatinib was replaced by nilotinib because of hematological toxicity. The patient had received nilotinib for about 3 years without significant adverse effects. She visited the clinic due to chronic cough; chest X-ray revealed consolidations in both lung fields. Nilotinib-induced ILD was diagnosed based on intensive workup, including lung biopsy. She responded dramatically to corticosteroid therapy. To our knowledge, this is the first reported case of nilotinib-induced ILD in a patient with Ph(+) CML. We emphasize that if unexplained lung abnormalities progress in patients receiving nilotinib, physicians should consider this potentially fatal complication in their differential diagnoses.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Benzamides / adverse effects
  • Benzamides / therapeutic use
  • Diagnosis, Differential
  • Drug Substitution
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Imatinib Mesylate
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Lung / pathology
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / pathology
  • Piperazines / adverse effects
  • Piperazines / therapeutic use
  • Prednisolone / administration & dosage
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Pyrimidines / adverse effects*
  • Pyrimidines / therapeutic use
  • Radiography, Thoracic
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Benzamides
  • Glucocorticoids
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate
  • Prednisolone
  • Protein-Tyrosine Kinases
  • nilotinib