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BMC Cancer. 2012; 12: 186.
Published online May 21, 2012. doi:  10.1186/1471-2407-12-186
PMCID: PMC3404905
Imatinib-induced liver cirrhosis in a patient with advanced gastrointestinal stroma tumor (GIST)
Christoph Seidel,corresponding author1 Martin Fenner,1 Florian Länger,3 Heike Bantel,2 Arnold Ganser,1 and Viktor Grünwald1
1Department of Hematology, Hemostasis, Oncology and Stem cell transplantation, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany
2Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany
3Institute of Pathology, Hannover Medical School, Oncology and Stem cell transplantation,, Carl-Neuberg Strasse 1, 30625, Hannover, Germany
corresponding authorCorresponding author.
Christoph Seidel: seidel.christoph/at/mh-hannover.de; Martin Fenner: fenner.martin/at/mh-hannover.de; Florian Länger: laenger.florian/at/mh-hannover.de; Heike Bantel: bantel.heike/at/mh-hannover.de; Arnold Ganser: ganser.arnold/at/mh-hannover.de; Viktor Grünwald: gruenwald.viktor/at/mh-hannover.de
Received October 4, 2011; Accepted May 21, 2012.
Abstract
Background
The use of imatinib mesylate is associated with a progression free survival of 41 months in first line treatment of metastatic or locally advanced gastrointestinal stromal tumors (GIST) and other studies approved that adjuvant imatinib treatment improves the recurrence-free survival in patients with GIST. Current recommendations include 1 year adjuvant treatment in GIST patients at risk but active studies explore different durations of treatment with an interval of up to 5 years. While the most frequent adverse events (AEs) are blood count alterations, abdominal discomfort and edema, the occurrence of grade 3 or 4 increase of AST or ALT is specified with 2.1% and 2.7% respectively.
Case presentation
We report a 49-year old male with a gastrointestinal stromal tumor (GIST) of the small bowel who developed liver cirrhosis under adjuvant imatinib treatment.
Conclusions
Our report supports the notion that imatinib-induced hepatotoxicity may lead to acute liver damage with subsequent cirrhotic remodelling. Patients developing grade 3 or 4 hepatotoxicity during imatinib treatment should therefore be carefully evaluated for chronic liver disease.
Keywords: GIST, Imatinib, Liver cirrhosis
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