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达沙替尼致慢性髓性白血病患者乳糜胸一例报告及文献复习

Dasatinib-induced chylothorax in a patient with chronic myeloid leukaemia: a case report and literature review.

作者信息

Hsu Chao-Chin, Hsu Jui-Feng, Wu Kuan-Li

机构信息

Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan.

出版信息

Respirol Case Rep. 2021 May 7;9(6):e00753. doi: 10.1002/rcr2.753. eCollection 2021 Jun.

Abstract

Dasatinib is a potent and effective second-generation oral tyrosine kinase inhibitor that is clinically indicated for the treatment of imatinib-resistant or imatinib-intolerant breakpoint cluster region-Abelson (BCR-ABL)-positive chronic myeloid leukaemia (CML) or for Philadelphia chromosome-positive acute lymphocytic leukaemia. The most common adverse events associated with dasatinib therapy are skin rash, gastrointestinal upset, pancytopenia, pulmonary hypertension, and fluid retention, including pleural effusion. However, chylothorax secondary to dasatinib administration has rarely been reported. Although the underlying mechanism leading to dasatinib-induced chylothorax is uncertain, the preferred treatment options are usually supported with diuretics or systemic steroids. Moreover, the discontinuation of the drug is mandatory in refractory cases. Here, we present the case of a patient with dasatinib-induced chylothorax, and review the previously reported cases in the literature.

摘要

达沙替尼是一种强效且有效的第二代口服酪氨酸激酶抑制剂,临床用于治疗对伊马替尼耐药或不耐受的断裂点簇集区-阿贝尔森(BCR-ABL)阳性慢性髓性白血病(CML)或费城染色体阳性急性淋巴细胞白血病。与达沙替尼治疗相关的最常见不良事件是皮疹、胃肠道不适、全血细胞减少、肺动脉高压和液体潴留,包括胸腔积液。然而,达沙替尼给药继发乳糜胸的情况鲜有报道。虽然导致达沙替尼诱导乳糜胸的潜在机制尚不确定,但首选治疗方案通常是使用利尿剂或全身性类固醇。此外,难治性病例必须停药。在此,我们报告一例达沙替尼诱导乳糜胸的患者病例,并回顾文献中先前报道的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4e9/8103079/248413e24dc1/RCR2-9-e00753-g001.jpg

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