Ivosidenib induction therapy complicated by myopericarditis and cardiogenic shock: A case report and literature review

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
Paula Hernandez BurgosAllan Chen

Abstract

Ivosidenib is a novel oral inhibitor of mutated isocitrate dehydrogenase 1 approved for the treatment of refractory or relapsed acute myeloid leukemia in patients with isocitrate dehydrogenase 1 mutations or as first-line agent in patients unable to tolerate chemotherapy. It is known to commonly cause differentiation syndrome, but an association with cardiovascular complications is not well established. We present the case of a 34-year-old female with relapsed acute myeloid leukemia post-allogeneic transplant who developed ivosidenib-induced differentiation syndrome complicated by myopericarditis and cardiogenic shock. Ivosidenib was discontinued, and aggressive management was pursued with high-dose steroids, ventilatory and pressure support and diuresis. She had significant improvement and later tolerated reintroduction of ivosidenib without recurrent episodes of differentiation syndrome or cardiac complications. To the best of our knowledge, this is the first reported case of myopericarditis and cardiogenic shock related to ivosidenib use. This case highlights the high index of suspicion required to recognize early signs of targeted therapy-related complications and exemplifies the beneficial collaborative role a cardio-oncol...Continue Reading

References

Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Apr 30, 2016·Journal of Pharmacology & Pharmacotherapeutics·Saket J ThakerUrmila M Thatte
Sep 14, 2018·Drugs·Sohita Dhillon

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Citations

Jan 19, 2021·The American Journal of Cardiology·Johnny ChahineAllan Klein
Dec 17, 2020·Life·Valentina GiudiceCarmine Selleri

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