Joint effusions/Gleevec

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" " a novel form of fluid retention presenting as multiple joint effusions

in a patient with advanced phase CML on high-dose imatinib, as well as

successful measures that were undertaken to control this adverse

event. " "

Eur J Haematol. 2006 May;76(5):444-6. Epub 2006 Mar 17.

Multiple joint effusions associated with high-dose imatinib therapy

in a patient with chronic myelogenous leukaemia.

JC, Dennehey CF, Anavim A, Kong KM, Tiong Ong S.

Division of Hematology and Oncology, College of Medicine, University

of California at Irvine, CA, USA.

Imatinib mesylate is a small molecule tyrosine kinase inhibitor that

has significant efficacy in the treatment of chronic myelogenous

leukaemia (CML). However, it is likely that patients with CML will

require prolonged and perhaps life-long therapy. In general, the

side-effects of imatinib therapy have been mild to moderate, with the

large majority of patients tolerating prolonged periods of therapy.

However, a minority of patients are completely intolerant of therapy,

while others are able to remain on therapy despite significant

side-effects. Here, we describe a novel form of fluid retention

presenting as multiple joint effusions in a patient with advanced phase

CML on high-dose imatinib, as well as successful measures that were

undertaken to control this adverse event. Although fluid retention,

including periorbital oedema, pleural and pericardial effusions, as well

as life-threatening cerebral oedema have been previously described and

attributed to imatinib, this is the first case of imatinib-associated

polyarticular effusions that we are aware of. Further work will be

required to confirm a casual relationship between imatinib therapy and

this novel side-effect, as well as to determine the underlying

pathophysiologic mechanisms.