Reversible pulmonary arterial hypertension related to dasatinib in the treatment for chronic myelogenous leukemia: a case report and literature review.
- Author:
Bingcheng LIU
1
;
Ying WANG
1
;
Yingchang MI
1
;
Jianxiang WANG
1
Author Information
- Publication Type:Case Reports
- MeSH: Dasatinib; Female; Humans; Hypertension, Pulmonary; chemically induced; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; drug therapy; Prognosis; Pyrimidines; adverse effects; Thiazoles; adverse effects; Young Adult
- From: Chinese Journal of Hematology 2014;35(7):581-586
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the clinical features and prognosis of pulmonary arterial hypertension associated with dasatinib.
METHODSTo present a case of pulmonary arterial hypertension (PAH) associated with long-term exposure to dasatinib and review the related literatures.
RESULTSA 23-year-old female with chronic myelogenous leukemia was treated with dasatinib at a dosage of 140 mg/d after failure of imatinib treatment and achieved complete cytogenetic response. The patient was presented with exertional dyspnea after 35 months of administration with dasatinib. The electrocardiogram showed right ventricular hypertrophy and right axis deviation; transthoracic Doppler echocardiography documented a reduction in diameters of left heart chambers with normal systolic left ventricular function, right heart chambers and pulmonary trunk dilatation, an estimated pulmonary arterial pressure of 114 mmHg; Computed tomography showed thickened pulmonary artery. PAH related to dasatinib was diagnosed and dasatinib was permanently discontinued. The symptom of dyspnea disappeared quickly after withdrawal of dasatinib. The heart structure and pulmonary arterial pressure completely recovered after 7 months of dasatinib discontinuation.
CONCLUSIONPAH is a rare adverse effect of dasatinib treatment. Echocardiograhpy, as a non-invasive screening test for PAH, should be performed before starting dasatinib treatment and repeated during the administration with dasatinib. Dasatinib should be withdrawn permanently in patients with PAH.