Liao Xin, Guo Yuxia, Shen Yali, Xiao Jianwen
Department of Hematology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China.
Case Rep Hematol. 2020 Feb 10;2020:5678210. doi: 10.1155/2020/5678210. eCollection 2020.
Dasatinib, a second-line tyrosine kinase inhibitor (TKI), has been widely used in chronic myeloid leukemia (CML) and Philadelphia-positive B-cell acute lymphoblastic leukemia (Ph + B-ALL). Although dasatinib has been well tolerated, side effects including hemorrhage are not rare. Cases of bleeding disorders ultimately result in thrombocytopenia, but platelet aggregation dysfunction induced by dasatinib has also been demonstrated in Ph + B-ALL and CML patients. We report three Chinese children with Ph + B-ALL who received a combination treatment of chemotherapy and dasatinib and developed gastrointestinal bleeding several months later. The platelet count and clotting tests were normal, and these patients presented with dasatinib-induced platelet dysfunction. These findings reveal that physicians should be aware of and carefully monitor for side effects, including bleeding disorders.
达沙替尼是一种二线酪氨酸激酶抑制剂（TKI），已广泛应用于慢性粒细胞白血病（CML）和费城染色体阳性的B细胞急性淋巴细胞白血病（Ph + B-ALL）。尽管达沙替尼耐受性良好，但包括出血在内的副作用并不罕见。出血性疾病最终会导致血小板减少，但达沙替尼诱导的血小板聚集功能障碍在Ph + B-ALL和CML患者中也得到了证实。我们报告了三名患有Ph + B-ALL的中国儿童，他们接受了化疗和达沙替尼的联合治疗，几个月后出现了胃肠道出血。血小板计数和凝血试验正常，这些患者表现为达沙替尼诱导的血小板功能障碍。这些发现表明，医生应意识到并仔细监测包括出血性疾病在内的副作用。
