And at the same time from gray hair
Chemotherapy of leukemia returned the color to the gray hair of an elderly Dutchman
Oleg Lischuk, N+1
Leukemia therapy performed on an elderly resident of the Netherlands, who was completely gray at the time of its onset, returned pigmentation to his hair. An unusual clinical case was reported in The New England Journal of Medicine observed the patient by doctors from the Albert Schweitzer Hospital in Dordrecht, province of South Holland.
Occasionally, graying of hair, or achromotrichia, appears due to third-party reasons, such as vitamin B12 deficiency, progeria and some other hereditary diseases, chronic malnutrition, taking some chemotherapeutic and antimalarial drugs, presumably inhibiting the c-kit receptor tyrosine kinase in pigment cells (melanocytes), heavy smoking and some others. Such gray hair, as a rule, appears prematurely, and in some cases is reversible when its cause is eliminated.
Primary graying is a normal component of the aging process, the time of its appearance is genetically determined. It is associated with the death of melanocytes in the hair follicles and is generally considered irreversible. One casuistic case of spontaneous return of pigmentation in a 38-year-old man was described in 1972 by the British doctor Stanley Comaish. In 2020, American researchers found molecular signs of gray hair reversibility in 14 volunteers, but in these cases, its clear relationship with stress levels was shown.
A patient of Dutch doctors, who was 51 years old at the time of the examination, 18 months earlier began receiving therapy for chronic myeloid leukemia with the second-generation tyrosine kinase inhibitor nilotinib orally. By that time, he had been completely gray for at least a year.
The patient's hair before and a year and a half after the start of treatment – VM.
During a routine examination, the man told oncologists that while taking nilotinib, he began to notice a gradual repigmentation of gray hair, as a result of which they almost completely returned to their natural color. The patient expressed his pleasure about this.
The survey and examination of the medical record showed that during therapy the man did not start or stop taking other medications and did not use any hair coloring products. In addition to the return of natural color, no changes in pigmentation of hair, skin and mucous membranes were observed. The examination showed a "pronounced response at the molecular level" — which one, the authors of the report do not specify; we can talk about the direct action of nilotinib, and about the production of melanin in hair follicles.
As a result, the patient was diagnosed with "drug-induced hair repigmentation caused by the use of a tyrosine kinase inhibitor." Given the improvement in the underlying disease, the patient was prescribed to continue taking nilotinib, and he did not start to turn gray again.
Considering that previously the opposite effect was observed when taking tyrosine kinase inhibitors (sunitinib, pazopanib and imatinib), the case of the Dutch patient looks very strange and can be considered a striking example of medical casuistry. It can be assumed that it is associated with hereditary polymorphism of the tyrosine kinase gene in melanocytes of hair follicles, which causes an atypical response to nilotinib, but there is no evidence of this. The instructions for the drug describe such side effects as alopecia (baldness) and hyperpigmentation of the skin, but not the elimination of gray hair.
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