Dasatinib combined with methotrexate and L-asparaginase in the treatment of patients with Philadelphia chromosome positive acute lymphoblastic leukemia cause severe drug-induced liver injury: one case report and literature review
10.3760/cma.j.issn.1009-9921.2015.11.008
- VernacularTitle:达沙替尼联合甲氨蝶呤和左旋门冬酰胺酶挽救性治疗费城染色体阳性急性淋巴细胞白血病致重度药物性肝损伤一例并文献复习
- Author:
Lu WANG
;
Xudong WEI
;
Qingsong YIN
;
Ping WANG
;
Ruihua MI
;
Hao AI
- Publication Type:Journal Article
- Keywords:
Philadelphia chromosome;
Leukemia,lymphoblastic,acute;
Tyrosine kinase inhibitor;
Methotrexate;
L-asparaginase;
Hepatotoxicity
- From:
Journal of Leukemia & Lymphoma
2015;24(11):668-671,675
- CountryChina
- Language:Chinese
-
Abstract:
Objective To improve the cognition of sever liver injury of treating Philadelphia positive acute lymphoblastic leukemia (Ph+ ALL) with salvage chemotherapy of dasatinib combined with high-dose methotrexate (HD-MTX) and L-asparaginase (L-Asp).Methods Severe drug-induced liver injury caused by dasatinib with HD-MTX and L-Asp in one patient with Ph+ ALL was reported.Results Severe drug-induced liver injury happened on the seventh day after treatment,TBIL 221.7 μmol/L,DBIL 156.1 μmol/L,IBIL 65.6 μmol/L,ALT 111 U/L,AST 131 U/L,ALP 354 U/L,GGT 256 U/L,TBA 199.2 μmol/L.Through proper treatment,the patient recovered quite good,and the patient achieved complete remission after this chemotherapy.Conclusion Salvage chemotherapy which contains dasatinib,MTX and L-Asp can be effectively used in Ph+ ALL,but they are all of the hepatotoxicity,so drug-induced Liver injury may happen while they are used together.
