Nakaya Aya, Fujita Shinya, Satake Atsushi, Nakanishi Takahisa, Azuma Yoshiko, Tsubokura Yukie, Hotta Masaaki, Yoshimura Hideaki, Ishii Kazuyoshi, Ito Tomoki, Nomura Shosaku
First Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Hematol Rep. 2018 Sep 5;10(3):7474. doi: 10.4081/hr.2018.7474.
Dasatinib is currently approved for clinical use as a first-line treatment agent for newly diagnosed chronic myeloid leukemia (CML). However, only a few clinical trials have been performed to evaluate dasatinibinduced PE following first-line therapy. We investigated the incidence and clinical features of dasatinib-induced PE following first-line therapy in Japanese CML patients of real world clinical practice settings. Among 22 patients, the median age of PE-positive patients was higher than that of PE-negative patients. Major molecular response was achieved in 75% of PE-positive patients and 50% of PE-negative patients. Most patients developed PE more than 1 year after treatment. Appearance of PE is associated with better clinical response during dasatinib treatment, however it is developed at any time. Elderly and high-risk patients tend to develop PE. The clinical features of dasatinib-induced PE following first-line therapy might be late onset and might not immediately follow the increasing of large granular lymphocyte.
达沙替尼目前被批准作为新诊断慢性髓性白血病(CML)的一线治疗药物用于临床。然而,仅有少数临床试验评估了一线治疗后达沙替尼诱导的噬血细胞性淋巴组织细胞增生症(PE)。我们在真实世界临床实践环境中的日本CML患者中,研究了一线治疗后达沙替尼诱导的PE的发生率和临床特征。在22例患者中,PE阳性患者的中位年龄高于PE阴性患者。75%的PE阳性患者和50%的PE阴性患者达到主要分子反应。大多数患者在治疗1年多后发生PE。PE的出现与达沙替尼治疗期间更好的临床反应相关,但可在任何时间发生。老年和高危患者倾向于发生PE。一线治疗后达沙替尼诱导的PE的临床特征可能是发病较晚,可能不会随着大颗粒淋巴细胞增多而立即出现。