Nilotinib-Induced Dystonia and Cognitive Deficits in a Neurologically Normal Patient with Chronic Myeloid Leukemia

Area of Science:

• Pharmacology
• Neurology
• Oncology

Background:

• Nilotinib is a tyrosine kinase inhibitor approved for chronic myeloid leukemia (CML).
• Emerging research suggests nilotinib's potential in neurodegenerative disorders like Parkinson's disease.
• Its use in neurological conditions is novel, with limited published data.

Observation:

• A patient with CML on nilotinib treatment developed new-onset neurological symptoms.
• The patient experienced intermittent dystonic posturing in the left upper extremity and cognitive impairment.
• These symptoms emerged after initiating nilotinib, improved with dose reduction, and reappeared upon re-administration.

Findings:

• This case report details the first instance of neurological symptoms potentially secondary to nilotinib use.
• The temporal relationship between nilotinib administration and symptom onset/resolution suggests a causal link.
• The underlying mechanisms for these nilotinib-induced neurological adverse effects remain unclear.

Implications:

• This case highlights the need for vigilance regarding potential neurological adverse effects of nilotinib, even in patients treated for CML.
• Further research is warranted to elucidate the mechanisms of nilotinib-induced neurotoxicity.
• Clinicians should consider nilotinib as a potential cause of new-onset neurological symptoms in patients.