Edahiro Yoko, Takaku Tomoiku, Konishi Hakuoh, Tsukune Yutaka, Fujioka Isao, Takasu Kiyoshi, Gotoh Akihiko, Daida Hiroyuki, Komatsu Norio
Department of Hematology, Juntendo University School of Medicine.
Department of Cardiovascular Medicine, Juntendo University School of Medicine.
Rinsho Ketsueki. 2017;58(11):2213-2218. doi: 10.11406/rinketsu.58.2213.
Pulmonary artery hypertension (PAH) has been reported to be a severe adverse event associated with dasatinib therapy. Among the 76 chronic myeloid patients who were treated with dasatinib at our hospital, six patients showed high estimated pulmonary arterial systolic pressure, as observed by echocardiography. PAH was confirmed using right heart catheterization in three (3.9%) patients with increased mean pulmonary artery pressure (mPAP). In one patient, although mPAP was higher than the normal range, it did not fulfill the criteria of pulmonary hypertension. After the discontinuation of dasatinib, BNP and dyspnea were improved in five patients. Therefore, it should be noted that dasatinib can cause PAH at higher rates than those reported previously, and if PAH is confirmed or suspected during dasatinib therapy, then dasatinib should be immediately discontinued.
据报道，肺动脉高压（PAH）是与达沙替尼治疗相关的严重不良事件。在我院接受达沙替尼治疗的76例慢性髓性白血病患者中，6例经超声心动图检查显示肺动脉收缩压估计值较高。通过右心导管检查确诊3例（3.9%）平均肺动脉压（mPAP）升高的患者患有PAH。在1例患者中，尽管mPAP高于正常范围，但未达到肺动脉高压的标准。停用达沙替尼后，5例患者的B型利钠肽（BNP）和呼吸困难症状有所改善。因此，应注意达沙替尼导致PAH的发生率高于先前报道，如果在达沙替尼治疗期间确诊或怀疑PAH，应立即停用达沙替尼。
