Nilotinib İlişkili Akut Pankreatit Olgusu

Yıl 2025, Cilt: 52 Sayı: 4, 903 - 907, 12.12.2025

Songül Beskisiz , Vehbi Demircan , Abdullah Karakuş , Orhan Ayyıldız

https://doi.org/10.5798/dicletip.1841291

Öz

Kronik Myeloid Lösemi (KML), tedavisinde tirozin kinaz inhibitörlerinin (TKI) kullanılmasıyla önemli bir başarı elde edilen myeloproliferatif bir neoplazmdır. İlk nesil TKI olan imatinibten sonra geliştirilen ikinci nesil ajanlardan biri olan nilotinib, KML hastalarında daha erken ve derin moleküler yanıtlar sağlayabilmektedir. Bununla birlikte nilotinib, nadir de olsa ciddi yan etkilere yol açabilir. Pankreas enzimlerinde asemptomatik yükseklik sık görülse de, nadiren akut pankreatit gelişebilir. Bu klinik tablo genellikle tedavinin erken dönemlerinde ortaya çıkarken, gecikmiş başlangıçlı akut pankreatit daha seyrek bildirilmektedir. Biz, nilotinib tedavisi altında uzun süredir tam moleküler yanıtla izlenen bir KML hastasında gelişen gecikmiş başlangıçlı akut pankreatit olgusunu sunmayı amaçladık.

Anahtar Kelimeler

Kronik myeloid lösemi , Nilotinib , Pankreatit

A Case of Nilotinib Associated Acute Pancreatitis

Öz

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm in which the introduction of tyrosine kinase inhibitors (TKIs) has significantly improved clinical outcomes. Nilotinib, a second generation TKI developed after imatinib, is known to induce earlier and deeper molecular responses in patients with CML. However, despite its favorable efficacy profile, nilotinib may occasionally lead to serious adverse effects. Asymptomatic elevations in pancreatic enzymes are commonly observed, whereas the occurrence of acute pancreatitis is rare. This clinical manifestation typically arises during the early phase of treatment, while delayed-onset pancreatitis has only rarely been described. We aimed to present a case of delayed-onset acute pancreatitis in a CML patient who had achieved and maintained a deep molecular response under longterm nilotinib therapy.

Anahtar Kelimeler

Chronic myeloid leukemia , Nilotinib , Pancreatitis.

Kaynakça

• 1.Thompson PA, Kantarjian HM, Cortes JE, et al.Diagnosis and treatment of chronic myeloidleukemia in 2015. Mayo Clin Proc. 2015; 90: 1440-54.
• 2.Wei G, Rafiyath S, Liu D. First-line treatment forchronic myeloid leukemia: Dasatinib, nilotinib, orimatinib. J Hematol Oncol. 2010; 3: 47.
• 3.Saglio G, Kim DW, Issaragrisil S, et al. Nilotinibversus imatinib for newly diagnosed chronicmyeloid leukemia. New England Journal of Medicine.2010; 362(24): 2251-9.doi:10.1056/NEJMoa0912614.
• 4.Shoukier M, Kantarjian HM, Jabbour E. Clinical orsub-clinical pancreatitis (PA) associated withnilotinib (Nb) as frontline for chronic myelogenousleukemia (CML). Blood. 2011; 118(21): 4443.
• 5.Tan Y, Ye Y, Zhou X. Nilotinib-induced liver injury:A case report. Medicine (Baltimore).2020;99(36):e22061.
• 6.Quinlan JD. Acute pancreatitis. Am Fam Physician.2014;90(9):632-9.
• 7.Simons-Linares CR, Elkhouly MA, Salazar MJ.Drug-induced acute pancreatitis in adults: Anupdate. Pancreas. 2019;48(10):1263-73.
• 8.Engel T, Justo D, Amitai M, et al. Nilotinib-associated acute pancreatitis. Ann Pharmacother.2013;47(1):e3.
• 9.Steegmann JL, Baccarani M, Breccia M, et al.European LeukemiaNet recommendations for themanagement and avoidance of adverse events oftreatment in chronic myeloid leukaemia. Leukemia.2016;30(8):1648–71.
• 10.Palandri F, Castagnetti F, Soverini S, et al.Pancreatic enzyme elevation in chronic myeloidleukemia patients treated with nilotinib afterimatinib failure. Haematologica. 2009;94(12):1758-61.
• 11.Wang S, Desikan SP, McClain JJ, et al. Delayedacute pancreatitis induced by nilotinib in a patientwith chronic myeloid leukemia attaining sustainedcomplete molecular response. EJHaem.2020;1(1):309-11.
• 12.Patel V, Pattisapu A, Attia K, et al. Nilotinib-induced acute pancreatitis in a patient with chronicmyeloid leukemia. Case Rep Gastroenterol.2017;11(2):344-7.
• 13.Yamada T, Nannya Y, Shimizu M, et al.Symptomatic acute pancreatitis induced bynilotinib: a report of two cases. Intern Med.2016;55(23):3495-7.