Development of pulmonary arterial hypertension during oral dasatinib therapy for chronic myelogenous leukemia

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  • MORISHITA Sakura
    Department of Hematology, Yokohama City University Medical Center
  • HAGIHARA Maki
    Department of Hematology, Yokohama City University Medical Center Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine
  • ITABASHI Megumi
    Department of Hematology, Yokohama City University Medical Center
  • ISHII Yoshimi
    Department of Hematology, Yokohama City University Medical Center
  • YAMAMOTO Wataru
    Department of Hematology, Yokohama City University Medical Center
  • NUMATA Ayumi
    Department of Hematology, Yokohama City University Medical Center
  • MOTOHASHI Kenji
    Department of Hematology, Yokohama City University Medical Center
  • MATSUMOTO Kenji
    Department of Hematology, Yokohama City University Medical Center
  • FUJISAWA Shin
    Department of Hematology, Yokohama City University Medical Center
  • NAKAJIMA Hideaki
    Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine

Bibliographic Information

Other Title
  • Dasatinib内服中に肺動脈性肺高血圧症を発症した慢性骨髄性白血病
  • 症例報告 第2回日本血液学会関東甲信越地方会 優秀演題 Dasatinib内服中に肺動脈性肺高血圧症を発症した慢性骨髄性白血病
  • ショウレイ ホウコク ダイ2カイ ニホン ケツエキ ガッカイ カントウ コウシンエツチホウカイ ユウシュウ エンダイ Dasatinib ナイフク チュウ ニ ハイ ドウミャクセイ ハイ コウケツアツショウ オ ハッショウ シタ マンセイ コツズイセイ ハッケツビョウ

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Abstract

<p>We present a 36-year-old woman who had been taking oral dasatinib for 3 years for the treatment of chronic myelogenous leukemia (CML). Although adverse events such as thrombocytopenia and pleural effusion developed, she showed a major molecular response (MMR) 22 months after the initiation of oral dasatinib administration, and the therapy was thus continued. Approximately 34 months after oral dasatinib initiation, she developed severe exertional dyspnea and had to be urgently hospitalized. There was no apparent pleural effusion increase, and neither imaging nor blood test results suggested pneumonia or other infections. Pulmonary arterial hypertension (PAH) was suspected on the basis of transthoracic echocardiography. PAH was then confirmed by right heart catheterization. Though dasatinib was discontinued on the day of hospitalization, pulmonary hypertension and heart failure progressed, and she did not respond to catecholamines or PDE5 (phosphodiesterase type 5) inhibitors. On the 4th hospital day, she experienced cardiopulmonary arrest and died 1 week later. Cases with PAH due to oral administration of dasatinib have been reported previously. However, cases showing the rapid progression documented in our patient are rare and we advocate that PAH be considered a potential adverse event associated with dasatinib therapy.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 57 (8), 999-1003, 2016

    The Japanese Society of Hematology

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