Imatinib Side Effect Management — RACP Adult Medicine MCQ

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EasyHaematologyImatinib Side Effect ManagementRACP Adult Medicine

A 55-year-old man with chronic myeloid leukaemia on imatinib develops periorbital oedema, muscle cramps, and diarrhoea. These side effects are bothersome but not severe. His response to treatment is optimal (BCR-ABL1 <0.1% at 12 months). What is the recommended management?

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Correct answer: E — Manage side effects symptomatically and continue imatinib

Periorbital oedema, muscle cramps, and diarrhoea are common non-severe side effects of imatinib (affecting 30–50% of patients). With an optimal molecular response, the priority is to maintain the current effective therapy and manage side effects symptomatically: diuretics or dose timing for oedema, quinine or magnesium for cramps, loperamide for diarrhoea. Switching to a second-generation TKI (dasatinib, nilotinib) should only be considered for intolerable side effects or treatment failure/warning. Dose reduction risks suboptimal response.

Reference: eTG – 2025 – Haematology; ELN – 2020 – CML Guidelines