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一例慢性髓性白血病患者经淋巴细胞转化试验诊断为达沙替尼诱导的出血性结肠炎

A Case of Dasatinib-Induced Hemorrhagic Colitis Diagnosed by the Lymphocyte Transformation Test in a Chronic Myeloid Leukemia Patient.

作者信息

Ahn Hongkeun, Kwon Ji Eun, Sohn Seong-Wook, Kwon Ji-Hyun, Kim Joo Sung, Yoon Sung-Soo, Kang Hye-Ryun, Hong Kyoung Sup

机构信息

Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Korea.

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.

出版信息

Indian J Hematol Blood Transfus. 2016 Jun;32(Suppl 1):96-99. doi: 10.1007/s12288-015-0528-z. Epub 2015 Mar 18.

Abstract

Dasatinib is an effective treatment option for patients diagnosed with Philadelphia chromosome positive chronic myeloid leukemia and who are non-responsive or intolerant to imatinib treatment. Dasatinib, however, is associated with various adverse effects and on rare occasions, may cause hemorrhagic colitis. We report the case of a 68-year-old male patient with dasatinib-induced hemorrhagic colitis, the first such case in Korea. Endoscopic biopsy of the transverse colon demonstrated non-specific inflammatory changes only. Cessation of dasatinib led to the resolution of symptoms, while reintroduction of the therapy led to the recurrence of his bloody diarrhea. To clarify the association between dasatinib and hemorrhagic colitis, the lymphocyte transformation test (LTT) was performed. The LTT result sustained a relatively high proliferation activity in the affected patient compared with almost no proliferation activity in normal control.

摘要

达沙替尼是诊断为费城染色体阳性慢性髓性白血病且对伊马替尼治疗无反应或不耐受患者的一种有效治疗选择。然而,达沙替尼会引发各种不良反应,且在极少数情况下可能导致出血性结肠炎。我们报告了一例68岁男性患者发生达沙替尼诱导的出血性结肠炎的病例,这是韩国首例此类病例。横结肠的内镜活检仅显示非特异性炎症改变。停用达沙替尼导致症状缓解,而重新使用该疗法则导致他的血性腹泻复发。为阐明达沙替尼与出血性结肠炎之间的关联,进行了淋巴细胞转化试验(LTT)。与正常对照几乎无增殖活性相比,该LTT结果显示患病患者具有相对较高的增殖活性。

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