# Imatinib-Induced Bone Marrow Aplasia in Chronic Myelogenous Leukemia

## TL;DR

A 63-year-old woman with chronic myelogenous leukemia developed severe bone marrow aplasia after taking imatinib, highlighting a rare but serious side effect.

## Contribution

This case report adds to the limited literature on imatinib-induced aplastic anemia and emphasizes the need for further research on TKI-related myelosuppression.

## Key findings

- The patient developed severe pancytopenia and hypocellular bone marrow four months after starting imatinib.
- Discontinuation of imatinib led to a slow recovery of blood counts.
- There is a lack of predictive criteria for myelosuppression caused by TKI therapy.

## Abstract

Imatinib is a tyrosine kinase inhibitor (TKI) and is a commonly used medication for treatment of chronic myelogenous leukemia (CML). Aplastic anemia is a very uncommon complication of Gleevec, and only a few cases are reported in the literature. We present a case of a 63-year-old Asian female who was initiated on imatinib for treatment of CML with good response in cell counts. Four months after Gleevec initiation, the patient was admitted to the hospital with extreme fatigue and noted to have severe pancytopenia. Patient received multiple blood transfusions. Finally, the patient underwent bone marrow biopsy, which showed concern for aplastic anemia with marked hypocellular bone marrow. Gleevec was held, blood counts were monitored, and supportive care was given. Patient had slow recovery of her blood counts. There remains scarcity of data on this topic and no criteria exist to predict the myelosuppression with TKI therapy. Our case report aims to reemphasize the need for increased research on myelosuppression with TKI therapy.