Goldblatt Mark, Huggins J Terrill, Doelken Peter, Gurung Puncho, Sahn Steven A
Division of Pulmonary and Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Am J Med Sci. 2009 Nov;338(5):414-7. doi: 10.1097/MAJ.0b013e3181ae9227.
Dasatanib, which has been approved for rescue therapy for patients with imatinib-resistant chronic myelogenous leukemia and Philadelphia chromosome positive acute lymphoblastic leukemia, is a novel, orally available multitargeted kinase inhibitor of BCR-ABL and SRC family kinases (Quintas-Cardama et al, J Clin Oncol 2007;25:3908-14). It binds to both active and inactive conformations of the ABL gene and is 325 times more potent than imatinib in inhibiting the growth of BCR/ABL cells in vitro (Morelock and Sahn, Chest 1999;116:212-21; Huggins and Sahn, Clin Chest Med 2004;25:141-53). Although dasatinib is a generally well-tolerated drug in the treatment of Philadelphia chromosome positive hematopoetic malignancies, pleural effusions have been frequently noted and have been reported in up to 35% of patients (Sahn SA. Drug-induced pleural disease. In: Camus P, Rosenow E, editors. Drug-induced iatrogenic lung disease. London: Hodder Arnold; 2009). Although there have been numerous reports of effusions, none have provided complete pleural fluid analysis; therefore, we report 2 patients with dasatinib-induced pleural effusion with complete pleural fluid analysis.
达沙替尼已被批准用于对伊马替尼耐药的慢性粒细胞白血病和费城染色体阳性急性淋巴细胞白血病患者的挽救治疗，它是一种新型的、口服有效的BCR-ABL和SRC家族激酶多靶点激酶抑制剂（昆塔斯 - 卡达马等人，《临床肿瘤学杂志》2007年；25:3908 - 14）。它能与ABL基因的活性和非活性构象结合，在体外抑制BCR/ABL细胞生长方面比伊马替尼强325倍（莫洛克和萨恩，《胸部》1999年；116:212 - 21；哈金斯和萨恩，《临床胸部医学》2004年；25:141 - 53）。尽管达沙替尼在治疗费城染色体阳性血液系统恶性肿瘤时通常耐受性良好，但胸腔积液却经常出现，据报道高达35%的患者会出现（萨恩SA。药物性胸膜疾病。载于：卡穆斯P，罗森纳E，编辑。药物性医源性肺病。伦敦：霍德·阿诺德；2009）。虽然有大量关于胸腔积液的报道，但均未提供完整的胸腔积液分析；因此，我们报告2例达沙替尼引起的胸腔积液患者，并进行了完整的胸腔积液分析。
