Choi Jae Ki, Cho Sung Yeon, Choi Su Mi, Kim Gyo Hui, Lee Sung Eun, Lee Seok, Kim Dong Wook, Lee Dong Gun
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Infect Chemother. 2018 Jun;50(2):153-159. doi: 10.3947/ic.2018.50.2.153.
Dasatinib, a tyrosine kinase inhibitor, is widely used for patients with chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia. Although the drug has a potent immunosuppressive effect, infectious complications during dasatinib treatment have been reported rarely. We describe five patients who developed cytomegalovirus (CMV) colitis during dasatinib treatment, in whom the colitis was initially confused with other causes. The patients, three with chronic myeloid leukemia, and two with acute lymphoblastic leukemia, were diagnosed with CMV colitis based on endoscopic and histologic findings. The patients who examined blood CMV polymerase chain reaction were all positive. The patients received antiviral therapy in the form of either ganciclovir or valganciclovir, and the overall treatment outcome was fair. These cases suggest that physicians should consider the possibility of CMV reactivation when treating diarrhea and/or hematochezia in patients on dasatinib.
达沙替尼是一种酪氨酸激酶抑制剂，广泛用于慢性髓性白血病和费城染色体阳性的急性淋巴细胞白血病患者。尽管该药物具有强大的免疫抑制作用，但关于达沙替尼治疗期间感染并发症的报道很少。我们描述了5例在达沙替尼治疗期间发生巨细胞病毒（CMV）结肠炎的患者，其结肠炎最初被误诊为其他病因。这些患者中，3例患有慢性髓性白血病，2例患有急性淋巴细胞白血病，根据内镜和组织学检查结果诊断为CMV结肠炎。检测血液CMV聚合酶链反应的患者均为阳性。患者接受了更昔洛韦或缬更昔洛韦形式的抗病毒治疗，总体治疗效果尚可。这些病例提示，医生在治疗服用达沙替尼的患者出现腹泻和/或便血时应考虑CMV再激活的可能性。
