Imatinib-induced postoperative periorbital purpura: GASP (Gleevec-Associated Surgical Purpura) in a woman with imatinib-treated chronic myelogenous leukemia

Dermatol Online J. 2014 Jan 15;20(1):21242.

Abstract

Background: Imatinib mesylate is a selective tyrosine kinase inhibitor used in the treatment of chronic myelogenous leukemia. Ocular side effects of imatinib include periorbital edema, which may become so severe as to obstruct the visual field.

Purpose: The purpose of this case study is to describe the clinical characteristics of imatinib- induced postoperative periorbital purpura.

Materials and methods: We retrospectively reviewed the medical literature using PubMed, searching the terms edema, Gleevec, imatinib, periorbital, postoperative and purpura. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented.

Results: Three patients have undergone surgery to reduce the imatinib-induced periorbital edema; two of these individuals have developed imatinib-induced postoperative periorbital purpura.

Conclusion: We recommend discontinuing imatinib usage one week prior to periorbital surgery and not resuming therapy until the eighth postoperative day.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Benzamides / administration & dosage
  • Benzamides / adverse effects*
  • Benzamides / therapeutic use
  • Blepharoplasty*
  • Drug Administration Schedule
  • Ecchymosis / chemically induced
  • Edema / chemically induced*
  • Edema / surgery
  • Eyelid Diseases / chemically induced*
  • Eyelid Diseases / surgery
  • Female
  • Humans
  • Hyperpigmentation / chemically induced
  • Imatinib Mesylate
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / enzymology
  • Male
  • Middle Aged
  • Piperazines / administration & dosage
  • Piperazines / adverse effects*
  • Piperazines / therapeutic use
  • Postoperative Complications / chemically induced*
  • Postoperative Hemorrhage / chemically induced
  • Preoperative Care
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use
  • Purpura / chemically induced*
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects*
  • Pyrimidines / therapeutic use
  • Retrospective Studies
  • Skin Transplantation

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate