Cytomegalovirus Colitis during Dasatinib Treatment for Patients with Hematologic Malignancy: Case Series and Literature Review
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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.
Abstract
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.
참고문헌 (17)
- Schade AE, "Dasatinib, a small-molecule protein tyrosine kinase inhibitor, inhibits T-cell activation and proliferation", Blood, 111, pp.1366~1377 (2008)
- Baccarani M, "Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet", J Clin Oncol, 27, pp.6041~6051 (2009)[DOI]
- Ottmann O, "Dasatinib induces rapid hematologic and cytogenetic responses in adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia with resistance or intolerance to imatinib: interim results of a phase 2 study", Blood, 110, pp.2309~2315 (2007)[DOI]
- de la Hoz RE, "Diagnosis and treatment approaches of CMV infections in adult patients", J Clin Virol, 25(Suppl 2), pp.S1~S12 (2002)
- Kmira Z, "Severe hemorrhagic colitis in a patient with chronic myeloid leukemia in the blastic phase after dasatinib use", World J Gastrointest Pathophysiol, 4, pp.59~62 (2013)[DOI]
- Torres HA, "Viral infection or reactivation in patients during treatment with dasatinib: a call for screening?", Leuk Lymphoma, 48, pp.2308~2309 (2007)[DOI]
- Kreutzman A, "Expansion of highly differentiated CD8+ T-cells or NK-cells in patients treated with dasatinib is associated with cytomegalovirus reactivation", Leukemia, 25, pp.1587~1597 (2011)[DOI]
- Yassin MA, "Cytomegalovirus-induced Hemorrhagic colitis in a patient with chronic myeloid leukemia (chronic phase) on dasatinib as an upfront therapy", Clin Med Insights Case Rep, 8, pp.77~81 (2015)
- Sunami Y, "Hemorrhagic colitis caused by dasatinib following cytomegalovirus enterocolitis in a patient with chronic myelogenous leukemia in the second chronic phase", Rinsho Ketsueki, 52, pp.282~286 (2011)
- Mera JR, "Cytomegalovirus pneumonia in adult nontransplantation patients with cancer: review of 20 cases occurring from 1964 through 1990", Clin Infect Dis, 22, pp.1046~1050 (1996)[DOI]
- 김성한, "Diagnostic Usefulness of Cytomegalovirus (CMV)- Specific T Cell Immunity in Predicting CMV Infection after Kidney Transplantation: A Pilot Proof-of- Concept Study", Infection and Chemotherapy, 47(2), pp.105~110 (2015), 대한감염학회[DOI]
- Lemonovich TL, "Update on cytomegalovirus infections of the gastrointestinal system in solid organ transplant recipients", Curr Infect Dis Rep, 14, pp.33~40 (2012)[DOI]
- Ko JH, "Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients", Clin Infect Dis, 60, pp.e20~e26 (2015)[DOI]
- Tanaka H, "Rapid and sustained increase of large granular lymphocytes and rare cytomegalovirus reactivation during dasatinib treatment in chronic myelogenous leukemia patients", Int J Hematol, 96, pp.308~319 (2012)[DOI]
- Chang H, "Cytomegalovirus infection in non-transplant patients with hematologic neoplasms: a case series", Chang Gung Med J, 34, pp.65~74 (2011)
- Torres HA, "Cytomegalovirus infection in patients with lymphoma: an important cause of morbidity and mortality", Clin Lymphoma Myeloma, 6, pp.393~398 (2006)[DOI]
- Eddleston M, "Severe cytomegalovirus infection in immunocompetent patients", Clin Infect Dis, 24, pp.52~56 (1997)[DOI]