Corticosteroids can reverse severe imatinib-induced hepatotoxicity.

BACKGROUND: Imatinib can induce severe hepatotoxicity, in 1-5% of CML patients, many of whom need permanent imatinib discontinuation. DESIGN AND RESULTS: We report 5 CML patients who developed grade 3-4 hepatotoxicity after 2-8 months in imatinib. Different aetiologies of liver damage were ruled out and toxicity recurred in 2 patients with further attempts at low dose imatinib. In all patients prednisone or methylprednisolone at 25- 40 mg/day resolved hepatotoxicity in 3-8 weeks and allowed imatinib to be resumed at full doses. Corticosteroid were tapered off in 3-5 months without hepatotoxicity recurrence. CONCLUSIONS: Corticosteroid may avoid discontinuation for hepatotoxicity of the most effective anti-CML therapy.