Hong Ji Hyung, Lee Sung-Eun, Choi Soo Young, Kim Soo-Hyun, Jang Eun-Jung, Bang Ju-Hee, Park Jin Eok, Jeon Hye-Rim, Oh Yun Jeong, Yi Jeong-Eun, Jung Hae Ok, Youn Ho Joong, Kim Dong-Wook
Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Cancer Res Treat. 2015 Oct;47(4):937-42. doi: 10.4143/crt.2013.155. Epub 2014 Nov 17.
We describe two cases of pulmonary arterial hypertension (PAH) that occurred under dasatinib treatment and were resolved after dasatinib discontinuation. Two patients with chronic phase chronic myeloid leukemia (CML) were switched to dasatinib therapy because of hematological progress while receiving imatinib. These patients had New York Heart Association (NYHA) functional class II dyspnea with elevated right ventricular systolic pressure (RVSP), which progressed under dasatinib treatment. After dasatinib treatment was discontinued, subjective symptoms were improved to NYHA functional class I and the follow-up transthoracic Doppler echocardiography showed improved RVSP. Treatment with an alternate tyrosine kinase inhibitor was initiated and had been continued without development of dyspnea or elevation of RVSP. This report suggests that dasatinib can cause the reversible PAH, therefore, routine cardiopulmonary evaluation before and during treatment with dasatinib may be needed in CML patients with clinical manifestations.
我们描述了两例在达沙替尼治疗期间发生肺动脉高压（PAH）并在停用达沙替尼后病情缓解的病例。两名慢性期慢性髓性白血病（CML）患者在接受伊马替尼治疗时因血液学进展而改用达沙替尼治疗。这些患者有纽约心脏协会（NYHA）II级呼吸困难，右心室收缩压（RVSP）升高，在达沙替尼治疗期间病情进展。停用达沙替尼治疗后，主观症状改善至NYHA I级，后续经胸多普勒超声心动图显示RVSP改善。开始使用另一种酪氨酸激酶抑制剂进行治疗，且持续治疗过程中未出现呼吸困难或RVSP升高。本报告提示达沙替尼可导致可逆性PAH，因此，对于有临床表现的CML患者，在达沙替尼治疗前和治疗期间可能需要进行常规心肺评估。
