Renal tuberculosis in an imatinib-treated chronic myeloid leukemia

Abstract

Imatinib, which inhibits tyrosine kinase activity of Bcr-Abl protein, is a standard form of treatment for chronic myeloid leukemia (CML). Through its immunomodulatory effect it affects T cell function in a number of ways. It inhibits antigen-induced T cell activation and proliferation. Antigen-specific T-cells and macrophages are vital for protection against Mycobacterium tuberculosis. Here we present a case of renal tuberculosis associated with imatinib therapy in the maintenance phase of CML. With granulomatous interstitial nephritis and positive tubercular DNA on renal biopsy, the condition was successfully treated with anti-tubercular therapy. This case provides support to the hypothesis that imatinib therapy in CML increases the susceptibility to tuberculosis and strict vigilance is required to enable its early detection and treatment.

Potential Repurposed Drug Candidates for Tuberculosis Treatment: Progress and Update of Drugs Identified in Over a Decade

“…Imatinib, upon administration, decreases the bacterial load and number of lesions in infected mice. It acted synergistically when given in combination with other standard anti-TB drugs. , A phase II B clinical trial (NCT03891901) is currently underway to determine the most effective dose of Imatinib that can be used as adjunctive therapy with TB treatment regimens (Rifabutin, Pyrazinamide, Isoniazid, and Ethambutol).…”

“…101,102 A phase II B clinical trial (NCT03891901) is currently underway to determine the most effective dose of Imatinib that can be used as adjunctive therapy with TB treatment regimens (Rifabutin, Pyrazinamide, Isoniazid, and Ethambutol). enzyme MtArgJ, exclusively present in M.tb, thereby blocking arginine production and impeding M.tb survival 103.…”

The Prospect of Repurposing Immunomodulatory Drugs for Adjunctive Chemotherapy against Tuberculosis: A Critical Review

“…Imatinib targets host tyrosine kinases and was originally designed for Abl kinase-driven cancers, though mouse model experiments of imatinib against TB show that its immunomodulatory effects are translatable [ 62 ]. Indeed, a recent case was of a chronic myeloid leukaemia patient undergoing imatinib therapy whose latent TB had reawakened [ 63 ]. A phase II trial is scheduled to commence shortly to investigate this (NCT03891901).…”

Tuberculose urogenital

“…Ainda assim, apesar do conhecimento comum dos defeitos imunológicos sistêmicos nestes pacientes, existem poucas informações sobre a função imunológica da mucosa. Na população tratada com agentes alquilantes convencionais, infecções comumente ocorrem em locais de mucosa, especialmente no trato respiratório 7,11 .…”