Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2019
Ivosidenib induction therapy complicated by myopericarditis and cardiogenic shock: A case report and literature review.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Hernandez Burgos Paula, Patel Jaymin, Chen Allan
Аннотация
INTRODUCTION: Ivosidenib is a novel oral inhibitor of mutated isocitrate dehydrogenase 1 approved for the treatment of refractory or relapsed acute myeloid leukemia in patients with isocitrate dehydrogenase 1 mutations or as first-line agent in patients unable to tolerate chemotherapy. It is known to commonly cause differentiation syndrome, but an association with cardiovascular complications is not well established.
CASE REPORT: We present the case of a 34-year-old female with relapsed acute myeloid leukemia post-allogeneic transplant who developed ivosidenib-induced differentiation syndrome complicated by myopericarditis and cardiogenic shock.
MANAGEMENT AND OUTCOME: Ivosidenib was discontinued, and aggressive management was pursued with high-dose steroids, ventilatory and pressure support and diuresis. She had significant improvement and later tolerated reintroduction of ivosidenib without recurrent episodes of differentiation syndrome or cardiac complications.
DISCUSSION: To the best of our knowledge, this is the first reported case of myopericarditis and cardiogenic shock related to ivosidenib use. This case highlights the high index of suspicion required to recognize early signs of targeted therapy-related complications and exemplifies the beneficial collaborative role a cardio-oncology team provides in improving patient care.
CASE REPORT: We present the case of a 34-year-old female with relapsed acute myeloid leukemia post-allogeneic transplant who developed ivosidenib-induced differentiation syndrome complicated by myopericarditis and cardiogenic shock.
MANAGEMENT AND OUTCOME: Ivosidenib was discontinued, and aggressive management was pursued with high-dose steroids, ventilatory and pressure support and diuresis. She had significant improvement and later tolerated reintroduction of ivosidenib without recurrent episodes of differentiation syndrome or cardiac complications.
DISCUSSION: To the best of our knowledge, this is the first reported case of myopericarditis and cardiogenic shock related to ivosidenib use. This case highlights the high index of suspicion required to recognize early signs of targeted therapy-related complications and exemplifies the beneficial collaborative role a cardio-oncology team provides in improving patient care.