Serious Thrombocytopenia After Imatinib Treatment For CML-CP:A Case Report And Literature Review

Objective:TKI has become the first choice for the treatment of chronic myeloid leukemia.Imatinib,as the first generation of TKI,has been widely recognized for its safety and efficacy.However,some patients still suffer from severe hematological adverse reactions during the treatment,which are difficult to tolerate.By analyzed a patient with chronic myeloid leukemia in chronic phase(CML-CP)suffered severe thrombocytopenia after treatment with imatinib,so as to improve the understanding of such events in clinical practice,timely detection,intervention and treatment.Methods:A case of the patient with chronic myeloid leukemia in chronic phase in our hospital was analyzed,the adverse reactions,course of treatment and prognosis of severe thrombocytopenia during imatinib treatment were analyzed and discussed in combination with relevant literature at home and abroad.Design: A case report.Resulte:(1)The patient was diagnosed with chronic myeloid leukemia in chronic phase and the use of imatinib is consistent with the criteria for the treatment of CML-CP;(2)Severe thrombocytopenia occurred during treatment with imatinib,there are no evidence of disease progression was found after reassessment of the condition.It was considered that the adverse reactions of thrombocytopenia were caused by imatinib,the thrombocytopenia could not be improved after withdrawal of imatinib and reduction combined with multiple plateletelet elevation therapies and Grade 3-4 thrombocytopenia was still recurrent.(3)It was considered that the patient was intolerance to imatinib,and when we turned to nilotinib and combined with Eltrombopag olamine,the patient's thrombocytopenia was improved.Concliusion:(1)When severe adverse reactions of grade 3-4 thrombocytopenia occerrence repeatedly in the CML-CP patients treated with imatinib,nilotinib should be selected for TKI conversion.If necessary,it can be combined with platelet-elevating drugs such as Eltrombopag olamine;(2)If there are more than two TKIs treatments and the patient's platelet is still repeatedly and persistently low,considering the intolerance to TKIs,it is suggested that hematopoietic stem cell transplantation should be performed as soon as possible.