Khan S, Bhartia S and Roy S
We report a rare case of a patient with chronic myeloid leukaemia (CML) who had severe drug hypersensitivity reactions with not only allopurinol and imatinib therapies for the CML, but also to a non-steroidal anti-inflammatory drug and an antibiotic. Each of the drugs (allopurinol and imatinib) when used alone, and in combination, had caused various combinations of fever (hyperpyrexia), rash and/or generalized edema. The patient had the HLA-B*58 haplotype that is associated with allopurinol induced Steven-Johnson syndrome. However, in our case, imatinib alone also caused a similar reaction. We discuss the other ‘at-risk’ HLA alleles and known drug reactions and that our patient was unfortunate to have all of these HLA alleles. Further studies are required to confirm whether the HLA-B*58 haplotype is a risk factor for imatinib induced adverse cutaneous drug reactions.