Clinical Spectrum of Bosutinib Related Side Effects in a Patient of CML: A Case Report and Review of Literature
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Abstract
This case study outlines the complex treatment journey of a 53-year-old male diagnosed with Chronic Myeloid Leukemia (CML). Despite initial therapy with Imatinib and a subsequent switch to Dasatinib and then Bosutinib due to treatment resistance and adverse effects, the patient experienced multiple unexpected complications, including bilateral pleural effusions, pulmonary arterial hypertension, renal impairment, and neurological symptoms. Bosutinib was identified as the likely cause, leading to its discontinuation and transition to Nilotinib, which resulted in a sustained molecular response without further adverse events. Through this case report and literature review, we aim to expand the dimensions of the toxicity profile of bosutinib.
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2. Keller G, Schafhausen P, Brummendorf TH. Bosutinib: a dual SRC/ABL kinase inhibitor for the treatment of chronic myeloid leukemia. Expert Rev Hematol. 2009;2(5):489-97.
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5. Weatherald J, Chaumais MC, Montani D. Pulmonary arterial hypertension induced by tyrosine kinase inhibitors. Curr Opin Pulm Med. 2017;23(5):392-7.
6. Watanabe N, Takaku T, Tsukune Y, et al. Bosutinib-induced lung injury: a report of two cases and literature review. Int J Hematol. 2022;115(6):902-5.
7. Cortes JE, Gambacorti-Passerini C, Kim DW, et al. Effects of Bosutinib Treatment on Renal Function in Patients With Philadelphia Chromosome-Positive Leukemias. Clin Lymphoma Myeloma Leuk. 2017;17(10):684-95.e6.
8. Abumiya M, Takahashi N, Takahashi S, et al. Effects of SLC22A2 808G>T polymorphism and bosutinib concentrations on serum creatinine in patients with chronic myeloid leukemia receiving bosutinib therapy. Sci Rep. 2021;11(1):6362.
9. Nakaya A, Ebitani M, Monzen T, et al. [A case of recurrent cerebral infarction during treatment with oral tyrosine kinase inhibitors for chronic myelogenous leukemia]. Rinsho Shinkeigaku. 2019;59(7):418-24.
10. Myoken Y, Fujita Y, Imanaka R, et al. Bosutinib-induced osteonecrosis of the jaw in a patient with chronic myeloid leukemia: a case report. Oral Maxillofac Surg. 2021;25(3):421-5.
11. Riou M, Seferian A, Savale L, et al. Deterioration of pulmonary hypertension and pleural effusion with bosutinib following dasatinib lung toxicity. Eur Respir J. 2016;48(5):1517–1519.
12. Takatsuka I, Hirata H, Takahashi T, et al. Successful treatment with nilotinib after bosutinib-induced pulmonary arterial hypertension recurrence following dasatinib in chronic myeloid leukemia in chronic phase. Leuk Res Rep. 2022;17:100312.
13. Seegobin K, Babbar A, Ferreira J, et al. A case of worsening pulmonary arterial hypertension and pleural effusions by bosutinib after prior treatment with dasatinib. Pulm Circ. 2017;7(4):808–812.
14. Yo S, Thenganatt J, Lipton J, et al. Incident pulmonary arterial hypertension associated with bosutinib. Pulm Circ. 2020;10(3):2045894020936913.
15. Hickey PM, Thompson AAR, Charalampopoulos A, et al. Bosutinib therapy resulting in severe deterioration of pre-existing pulmonary arterial hypertension. Eur Respir. J. 2016;48(5):1514–1516.
16. Farinha I, Gaiao Santos J, Cunha A, et al. Chylothorax as an unusual presentation of Bosutinib therapy toxicity. Pulmonology. 2023;29(4):345-6.
17. Aslan NA, Hincal HO, Elver O, et al. Bosutinib-induced massive pleural effusion: Cross-intolerance with all tyrosine kinase inhibitors. J Oncol Pharm Pract. 2023;29(2):511-516.
18. Liu QS, Ass'ad NA, Arana Yi C. Bosutinib-associated interstitial lung disease and pleural effusion: A case report and literature review. Clin Case Rep. 2021;9(5):e03164.
2. Keller G, Schafhausen P, Brummendorf TH. Bosutinib: a dual SRC/ABL kinase inhibitor for the treatment of chronic myeloid leukemia. Expert Rev Hematol. 2009;2(5):489-97.
3. Kong JH, Khoury HJ, Kim AS, et al. The safety of Bosutinib for the treatment of chronic myeloid leukemia. Expert Opin Drug Saf. 2017;16(10):1203-9.
4. Isfort S, Crysandt M, Gezer D, et al. Bosutinib: A Potent Second-Generation Tyrosine Kinase Inhibitor. Recent Results Cancer Res. 2018;212:87-108.
5. Weatherald J, Chaumais MC, Montani D. Pulmonary arterial hypertension induced by tyrosine kinase inhibitors. Curr Opin Pulm Med. 2017;23(5):392-7.
6. Watanabe N, Takaku T, Tsukune Y, et al. Bosutinib-induced lung injury: a report of two cases and literature review. Int J Hematol. 2022;115(6):902-5.
7. Cortes JE, Gambacorti-Passerini C, Kim DW, et al. Effects of Bosutinib Treatment on Renal Function in Patients With Philadelphia Chromosome-Positive Leukemias. Clin Lymphoma Myeloma Leuk. 2017;17(10):684-95.e6.
8. Abumiya M, Takahashi N, Takahashi S, et al. Effects of SLC22A2 808G>T polymorphism and bosutinib concentrations on serum creatinine in patients with chronic myeloid leukemia receiving bosutinib therapy. Sci Rep. 2021;11(1):6362.
9. Nakaya A, Ebitani M, Monzen T, et al. [A case of recurrent cerebral infarction during treatment with oral tyrosine kinase inhibitors for chronic myelogenous leukemia]. Rinsho Shinkeigaku. 2019;59(7):418-24.
10. Myoken Y, Fujita Y, Imanaka R, et al. Bosutinib-induced osteonecrosis of the jaw in a patient with chronic myeloid leukemia: a case report. Oral Maxillofac Surg. 2021;25(3):421-5.
11. Riou M, Seferian A, Savale L, et al. Deterioration of pulmonary hypertension and pleural effusion with bosutinib following dasatinib lung toxicity. Eur Respir J. 2016;48(5):1517–1519.
12. Takatsuka I, Hirata H, Takahashi T, et al. Successful treatment with nilotinib after bosutinib-induced pulmonary arterial hypertension recurrence following dasatinib in chronic myeloid leukemia in chronic phase. Leuk Res Rep. 2022;17:100312.
13. Seegobin K, Babbar A, Ferreira J, et al. A case of worsening pulmonary arterial hypertension and pleural effusions by bosutinib after prior treatment with dasatinib. Pulm Circ. 2017;7(4):808–812.
14. Yo S, Thenganatt J, Lipton J, et al. Incident pulmonary arterial hypertension associated with bosutinib. Pulm Circ. 2020;10(3):2045894020936913.
15. Hickey PM, Thompson AAR, Charalampopoulos A, et al. Bosutinib therapy resulting in severe deterioration of pre-existing pulmonary arterial hypertension. Eur Respir. J. 2016;48(5):1514–1516.
16. Farinha I, Gaiao Santos J, Cunha A, et al. Chylothorax as an unusual presentation of Bosutinib therapy toxicity. Pulmonology. 2023;29(4):345-6.
17. Aslan NA, Hincal HO, Elver O, et al. Bosutinib-induced massive pleural effusion: Cross-intolerance with all tyrosine kinase inhibitors. J Oncol Pharm Pract. 2023;29(2):511-516.
18. Liu QS, Ass'ad NA, Arana Yi C. Bosutinib-associated interstitial lung disease and pleural effusion: A case report and literature review. Clin Case Rep. 2021;9(5):e03164.
| Files | ||
| Issue | Vol 19 No 3 (2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| Bosutinib; Chronic myeloid leukemia; Bosutinib toxicity; Pulmonary arterial hypertension; Pleural effusion | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sharma V, Mahajan S, Bagrodia V, Grover J, Oberoi V. Clinical Spectrum of Bosutinib Related Side Effects in a Patient of CML: A Case Report and Review of Literature. Int J Hematol Oncol Stem Cell Res. 2025;19(3):291-295.
