Skip to main content

Advertisement

SpringerLink
Log in

Bosutinib-induced osteonecrosis of the jaw in a patient with chronic myeloid leukemia: a case report

  • Case Report
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon adverse drug reaction that can be induced by certain therapeutic drugs, including antiresorptive and antiangiogenic agents. Here, we describe the first case of ONJ induced by bosutinib, a tyrosine kinase inhibitor, in a patient with chronic myeloid leukemia (CML) who was not taking an antiresorptive agent. A 65-year-old male with no history of either antiresorptive treatment or dental surgery but diagnosed with CML had been undergoing treatment with bosutinib for 2 years. He developed right mandibular stage 2 osteonecrosis. The patient eventually underwent extensive surgery consisting of removal of the necrotic bone and infected soft tissue in combination with nasolabial flap reconstruction. He obtained complete resolution of MRONJ at 12 months postoperatively. As new cancer therapies become available, it is important that clinicians are aware of this novel case of bosutinib-induced ONJ in a patient undergoing CML treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O’Ryan F (2014) American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. J Oral Maxillofac Surg 72:1938–1956

    Article  Google Scholar 

  2. Nicolatou-Galitis O, Kouri M, Papadopoulou E, Vardas E, Galiti D, Epstein JB, Elad S, Campisi G, Tsoukalas N, Bektas-Kayhan K, MASCC Bone Study Group et al (2019) Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review. Support Care Cancer 27:383–394

    Article  Google Scholar 

  3. Abel Mahedi Mohamed H, Nielsen CEN, Schiodt M (2018) Medication related osteonecrosis of the jaws associated with targeted therapy as monotherapy and in combination with antiresorptives. A report of 7 cases from the Copenhagen Cohort. Oral Surg Oral Med Oral Pathol Oral Radiol 125:157–163

    Article  Google Scholar 

  4. Won AM, Boddu P, Otun AO, Aponte-Wesson R, Chambers M (2018) Chronic myelogenous leukemia presenting with osteonecrosis of the jaw as a rare but debilitating toxicity of dasatinib: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 126:e208–e211

    Article  Google Scholar 

  5. Vivano M, Rossi M, Cocca S (2017) A rare case of osteonecrosis of the jaw related to imatinib. J Korean Assoc Oral Maxillofac Surg 43:120–124

    Article  Google Scholar 

  6. Mauceri R, Panzarella V, Morreale I, Campisi G (2019) Medication-related osteonecrosis of the jaw in a cancer patient receiving lenvatinib. Int J Oral Maxillofac Surg 48:1530–1532

    Article  CAS  Google Scholar 

  7. Akkach S, Shukla L, Morgan D (2019) Everolimus-induced osteonecrosis of the jaw in the absence of bisphosphonates: a case report. Br J Oral Maxillofac Surg 57:688–690

    Article  CAS  Google Scholar 

  8. Cortes JE, Apperley JF, DeAngelo DJ, Deininger MW, Kota VK, Rousselot P, Gambacorti-Passerini C (2018) Management of adverse events associated with bosutinib treatment of chronic-phase chronic myeloid leukemia: expert panel review. J Hematol Oncol 11:143

    Article  CAS  Google Scholar 

  9. Cortes JE, Gambacorti-Passerini C, Deininger MW, Mauro MJ, Chuah C, Kim DW, Dyagil I, Glushko N, Milojkovic D, le Coutre P, Garcia-Gutierrez V, Reilly L, Jeynes-Ellis A, Leip E, Bardy-Bouxin N, Hochhaus A, Brümmendorf TH (2018) Bosutinib versus Imatinib for newly diagnosed chronic myeloid leukemia: results from the randomized BFORE trial. J Clin Oncol 36:231–237

    Article  CAS  Google Scholar 

  10. Lemound J, Muecke T, Zeller AN, Lichtenstein J, Eckardt A, Gellrich NC (2018) Nasolabial flap improves healing in medication-related osteonecrosis of the jaw. J Oral Maxillofac Surg 76:877–885

    Article  Google Scholar 

  11. Bieerkehazhi S, Chen Z, Zhao Y, Yu Y, Zhang H, Vasudevan SA, Woodfield SE, Tao L, Yi JS, Muscal JA, Pang JC, Guan S, Zhang H, Nuchtern JG, Li H, Li H, Yang J (2017) Novel Src/Abl tyrosine kinase inhibitor bosutinib suppresses neuroblastoma growth via inhibiting Src/Abl signaling. Oncotarget 8:1469–1480

    Article  Google Scholar 

  12. Gover-Proaktor A, Granot G, Pasmanik-Chor M, Pasvolsky O, Shapira S, Raz O, Raanani P, Leader A (2019) Bosutinib, dasatinib, imatinib, nilotinib, and ponatinib differentially affect the vascular molecular pathways and functionality of human endothelial cells. Leuk Lymphoma 60:189–199

    Article  CAS  Google Scholar 

  13. Hayashida S, Soutome S, Yanamoto S, Fujita S, Hasegawa T, Komori T, Kojima Y, Miyamoto H, Shibuya Y, Ueda N, Kirita T, Nakahara H, Shinohara M, Umeda M (2017) Evaluation of the treatment strategies for medication-related osteonecrosis of the jaws (MRONJ) and the factors affecting treatment outcome: a multicenter retrospective study with propensity score matching analysis. J Bone Miner Res 32:2022–2029

    Article  CAS  Google Scholar 

  14. Mücke T, Koerdt S, Jung M, Mitchell DA, Wolff KD, Kesting MR, Loeffelbein DJ (2016) The role of mylohyoid flap in the treatment of bisphosphonate-related osteonecrosis of the jaws. J Craniomaxillofac Surg 44:369–373

    Article  Google Scholar 

  15. Myoken Y, Fujita Y, Okamoto T (2020) Modified submental island flap for the surgical treatment of 4 patients with stage 3 medication-related osteonecrosis of the mandible. J Oral Maxillofac Surg 78:29–34

    Article  Google Scholar 

  16. Myoken Y, Fujita Y, Kawamoto K, Toratani S (2020) Osteonecrosis of the jaw in a metastatic lung cancer patient with bone metastases undergoing pembrolizumab+denosumab combination therapy: case report and literature review. Oral Oncol 27:104874. https://doi.org/10.1016/j.oraloncology.2020.104874

    Article  CAS  Google Scholar 

  17. Ristow O, Rückschloß T, Moratin J, Müller M, Kühle R, Dominik H, Pilz M, Shavlokhova V, Otto S, Hoffmann J et al (2020) Wound closure and alveoplasty after preventive tooth extractions in patients with antiresorptive intake-a randomized pilot trial. Oral Dis 2020:17. https://doi.org/10.1111/odi.13556

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Senda-machi, Naka-ku, Hiroshima, 730-0052, Japan

    Yoshinari Myoken & Yoshinori Fujita

  2. Department of Hematology, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Ryota Imanaka

  3. Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Shigeaki Toratani

Authors
  1. Yoshinari Myoken
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshinori Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ryota Imanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigeaki Toratani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YM and ST designed and YM wrote the paper. YM, YF, and RI performed the examination. YM and YF performed the surgery. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yoshinari Myoken.

Ethics declarations

Competing interests

The authors declare that they have no competing interest.

Ethical approval

This report was approved by the Institutional Review Board of Hiroshima Red Cross & Atomic-bomb Survivors Hospital (approval no. H 30-645).

Patient consent

Written consent was obtained for publication.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Myoken, Y., Fujita, Y., Imanaka, R. et al. Bosutinib-induced osteonecrosis of the jaw in a patient with chronic myeloid leukemia: a case report. Oral Maxillofac Surg 25, 421–425 (2021). https://doi.org/10.1007/s10006-020-00931-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-020-00931-x

Keywords

Search

Navigation