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Long induction of tolerance to imatinib
  1. Leyla Bojanini1,
  2. Steven Attia2,
  3. Haesuk Heagney3 and
  4. Alexei Gonzalez-Estrada4
  1. 1Medicine, Mayo Clinic, Jacksonville, Florida, USA
  2. 2Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida, USA
  3. 3Department of Pharmacy, Mayo Clinic, Jacksonville, Florida, USA
  4. 4Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, Jacksonville, Florida, USA
  1. Correspondence to Dr Alexei Gonzalez-Estrada; gonzalez.alexei{at}


Imatinib is used to treat several haematological and solid malignancies. Cutaneous side effects could often limit the use of this medication. We present a case of a 62-year-old woman with a history of a gastrointestinal stromal tumour that developed a delayed cutaneous adverse reaction 10 days after starting imatinib 400 mg daily. She developed the same symptoms with reintroduction at a dose of 100 mg and with an alternative tyrosine kinase inhibitor, nilotinib 50 mg/day. Given that imatinib was considered her best treatment, she underwent a long induction of drug tolerance (IDT) protocol to imatinib. Patient tolerated the medication without further reactions for 6 months and had improvement of her cancer per last imaging studies. IDT should be considered in delayed hypersensitivity reactions to imatinib after a failed reintroduction of the drug or when no other equally effective agents are available.

  • haematology (drugs and medicines)
  • malignant disease and immunosuppression
  • immunology

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  • Contributors LB, SA and HH contributed to data generation, analysis and interpretation of the study and preparation of the manuscript; AG-E contributed to conception and design of the study, data generation and analysis and interpretation of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.