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Open Access Case report

Imatinib-induced liver cirrhosis in a patient with advanced gastrointestinal stroma tumor (GIST)

Christoph Seidel1*, Martin Fenner1, Florian Länger3, Heike Bantel2, Arnold Ganser1 and Viktor Grünwald1

Author Affiliations

1 Department of Hematology, Hemostasis, Oncology and Stem cell transplantation, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany

2 Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany

3 Institute of Pathology, Hannover Medical School, Oncology and Stem cell transplantation,, Carl-Neuberg Strasse 1, 30625, Hannover, Germany

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BMC Cancer 2012, 12:186  doi:10.1186/1471-2407-12-186

Published: 21 May 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