Miura Shogo, Murase Kazuyuki, Sakurada Akira, Takada Kohichi, Iyama Satoshi, Sato Tsutomu, Sato Yasushi, Miyanishi Koji, Kobune Masayoshi, Muranaka Atsuko, Tachibana Kazutoshi, Kato Junji
Dept. of Medical Oncology and Hematology, Sapporo Medical University.
Gan To Kagaku Ryoho. 2017 Jun;44(6):529-531.
A 64-year-old man was diagnosed with chronic-phase chronic myelogenous leukemia(CML)in May 2009. He was treated with imatinib and achieved complete cytogenetic response(CCyR)in 2 months. After 4 months of treatment, he developed interstitial pneumonia and became intolerant to imatinib. He was then switched to nilotinib from October of the same year. In June 2013, he was diagnosed with drug-induced pericarditis resulting from nilotinib use, and thus, nilotinib was discontinued. Subsequently, he was followed up without specific treatment for CML. In January 2014, he was admitted to the Dept. of Cardiovascular, Renal and Metabolic Medicine at our hospital because of heart failure. After examinations of cardiac function, he was diagnosed with constrictive pericarditis. Therefore, pericardiolysis was performed by the Dept. of Cardiovascular Surgery at our hospital. Pathologic findings showed hyaline-like fibrous tissue proliferation in the pericardium, which was diagnosed as fibrous pericarditis induced by nilotinib. We report a case of chronic myelogenous leukemia that developed fibrous pericarditis owing to nilotinib use.
一名64岁男性于2009年5月被诊断为慢性期慢性髓性白血病（CML）。他接受了伊马替尼治疗，并在2个月内达到完全细胞遗传学缓解（CCyR）。治疗4个月后，他出现间质性肺炎，对伊马替尼不耐受。同年10月，他改用尼洛替尼。2013年6月，他被诊断为使用尼洛替尼引起的药物性心包炎，因此停用了尼洛替尼。随后，他未接受CML的特异性治疗进行随访。2014年1月，他因心力衰竭入住我院心血管、肾脏和代谢医学科。经心脏功能检查后，他被诊断为缩窄性心包炎。因此，我院心血管外科进行了心包松解术。病理结果显示心包内有透明样纤维组织增生，诊断为尼洛替尼引起的纤维性心包炎。我们报告一例因使用尼洛替尼而发生纤维性心包炎的慢性髓性白血病病例。
