CNS DEMYELINATION IN PATIENTS ON NILOTINIB TREATMENT FOR CML
- Resource Type
- Authors
- Elissa Rekhi; Mamta Sohal; Pooja Dassan; Angharad Pryce
- Source
- Journal of Neurology, Neurosurgery & Psychiatry. 87:e1.62-e1
- Subject
- 0301 basic medicine
Pathology
medicine.medical_specialty
medicine.drug_class
business.industry
CNS demyelination
Cervical cord
Periventricular white matter
Tyrosine-kinase inhibitor
Right hand weakness
03 medical and health sciences
Psychiatry and Mental health
030104 developmental biology
0302 clinical medicine
Methylprednisolone
Nilotinib
hemic and lymphatic diseases
medicine
Surgery
In patient
Neurology (clinical)
business
030217 neurology & neurosurgery
medicine.drug
- Language
- ISSN
- 1468-330X
0022-3050
Nilotinib is a second-generation tyrosine kinase inhibitor targeting the BCR-ABL translocation in chronic myeloid leukaemia (CML). We present two cases of central nervous (CNS) demyelination whilst on treatment with Nilotinib, which to the best of our knowledge has not previously been documented. The first case is of a 36-year-old man diagnosed with CML 5 years ago. He presented 3 years into treatment with right-sided facial parasthesia and right hand weakness. MRI scans revealed multiple foci of increased signal intensity predominantly of the periventricular white matter in keeping with demyelination. Nilotinib was held and a course of IV methylprednisolone commenced with resolution of symptoms. The second case is of a 39-year-old lady diagnosed with CML. 2 years into treatment she reported sensory disturbance in the right neck and arm. An MRI showed multiple foci of increased signal density in the periventricular white matter as well as lesions in the cervical cord suggestive of demyelination. Her symptoms spontaneously resolved without discontinuing Nilotinib. These similar cases have raised the possibility of an association with Nilotinib and CNS demyelination. Although likely to be a rare phenomenon, clinicians should have a low threshold for considering demyelination in patients presenting with neurological symptoms.