Focal Segmental Sclerosis Associated with the Novel Multi-tyrosine Kinase Inhibitor Ponatinib

Intern Med. 2023 Sep 15;62(18):2693-2698. doi: 10.2169/internalmedicine.1283-22. Epub 2023 Jan 15.

Abstract

Ponatinib is a novel multi-tyrosine kinase inhibitor (TKI) with potent inhibitory activity against refractory chronic myeloid leukemia (CML). Despite its high clinical efficacy, ponatinib induces various adverse events due to its multi-target characteristic. However, renal complications associated with ponatinib are rare. A 76-year-old woman had a history of chronic myeloid leukemia (CML) resistant to imatinib and nilotinib. Our patient developed proteinuria and renal function deterioration during treatment with ponatinib but not with imatinib or nilotinib. We herein report the first case of a patient with secondary focal segmental glomerulosclerosis (FSGS) with partial glomerular collapse induced by ponatinib treatment.

Keywords: endothelial injury; focal segmental glomerulosclerosis; ponatinib; tyrosine kinase inhibitor; vascular endothelial growth factor receptor (VEGFR).

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents* / adverse effects
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / complications
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Protein Kinase Inhibitors / adverse effects
  • Pyridazines* / adverse effects
  • Pyrimidines / therapeutic use
  • Sclerosis
  • Tyrosine Kinase Inhibitors

Substances

  • Imatinib Mesylate
  • Antineoplastic Agents
  • ponatinib
  • Tyrosine Kinase Inhibitors
  • Protein Kinase Inhibitors
  • Pyridazines
  • Pyrimidines