Complete Recovery from Dasatinib-induced Pulmonary Arterial Hypertension after Successful Discontinuation of Tyrosine Kinase Inhibitor in A Case of Chronic Myeloid Leukemia

慢性骨髓性白血病患者服用dasatinib導致的肺高壓在停藥後復原，且不需再服用酪胺酸激酶抑制劑：病例報告

10.6314/JIMT.201904_30(2).10

施恩潔(En-Jie Shih)；宋思賢(Shih-Hsien Sung)；高志平(Jyh-Pyng Gau)

Chronic myeloid leukemia ； Dasatinib ； Pulmonary arterial hypertension ； Tyrosine kinase inhibitor

內科學誌

30卷2期（2019 / 04 / 01）

161 - 165

英文

Chronic myeloid leukemia could be treated by tyrosine kinase inhibitor successfully. However, a few rare but lethal adverse reactions have been reported. In cases of dasatinib-induced pulmonary arterial hypertension (PAH), the majority generally recovers incompletely and needs alternative TKIs for CML treatment. A 34-year-old woman diagnosed with chronic myeloid leukemia (CML) had taken dasatinib for more than two years. Before dasatinib, she had been under nilotinib treatment for two years, achieving complete molecular response at sixth months, but with persistent hyperbilirubinemia and epigastric discomfort. Twenty months after shifting to dasatinib, she began to experience shortness of breath. Severe pulmonary arterial hypertension was subsequently diagnosed. After withdrawal of dasatinib, the PAH thoroughly resolved. Moreover, complete molecular response was maintained for more than two years without additional tyrosine kinase inhibitor (TKIs) administration. The strength of our case is that the patient fully recovered from the dasatinib-induced severe PAH and kept complete molecular response without taking other TKIs. Early detection of the adverse effect of dasatinib is important for better outcomes.

隨著酪胺酸激酶抑制劑的使用，慢性骨髓性白血病患者的壽命有了大幅增長，然而，有些罕見而致命的副作用如dasatinib造成的肺高壓，常常導致病人不可逆的傷害，且之後仍需使用他種酪胺酸激酶抑制劑以治療慢性骨髓性白血病。在我們的病例中，病人因及早發現dasatinib造成的肺高壓而停藥並接受治療，之後成功的完全恢復，且不須再使用其他酪胺酸激酶抑制劑。