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Bone Marrow Aplasia Under Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: A Rare and Unpredictable Complication

Year: 2026

Type: article

Abstract: Tyrosine kinase inhibitor (TKI)-induced bone marrow aplasia is a rare but potentially severe complication of chronic myeloid leukemia (CML). We report two cases occurring under imatinib and nilotinib in patients with chronic-phase CML. The first case, occurring six months after imatinib initiation, was characterized by severe bone marrow aplasia associated with gelatinous marrow transformation, a rare histological finding in TKI-treated CML. The second case, occurring two months after switching to nilotinib, evolved toward non-severe bone marrow aplasia, with complete hematologic recovery after treatment discontinuation. These observations illustrate the heterogeneity and unpredictability of this toxicity, which may occur across different TKI generations and levels of molecular response. Immediate TKI discontinuation remains essential, and any persistent pancytopenia should prompt early bone marrow evaluation to ensure a timely diagnosis and appropriate management.

Source: Cureus

DOI: 10.7759/cureus.117060

Authors: Morad Annasser, Omar Halloumi, Rida Fatima ezzahra, Salma Fares

Institutions: Centre Hospitalier Universitaire Mohammed VI, Institut Jules Bordet, Université Ibn Zohr

Language: English

Topic: Chronic Myeloid Leukemia Treatments

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214626082