Reversible Pulmonary Arterial Hypertension Associated with Dasatinib for Chronic Myeloid Leukemia
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We describe two cases of pulmonary arterial hypertension (PAH) that occurred underdasatinib treatment and were resolved after dasatinib discontinuation. Two patientswith chronic phase chronic myeloid leukemia (CML) were switched to dasatinib therapybecause of hematological progress while receiving imatinib. These patients hadNew York Heart Association (NYHA) functional class II dyspnea with elevated rightventricular systolic pressure (RVSP), which progressed under dasatinib treatment. After dasatinib treatment was discontinued, subjective symptoms were improved toNYHA functional class I and the follow-up transthoracic Doppler echocardiographyshowed improved RVSP. Treatment with an alternate tyrosine kinase inhibitor wasinitiated and had been continued without development of dyspnea or elevation ofRVSP. This report suggests that dasatinib can cause the reversible PAH, therefore,routine cardiopulmonary evaluation before and during treatment with dasatinib maybe needed in CML patients with clinical manifestations.
Abstract
We describe two cases of pulmonary arterial hypertension (PAH) that occurred underdasatinib treatment and were resolved after dasatinib discontinuation. Two patientswith chronic phase chronic myeloid leukemia (CML) were switched to dasatinib therapybecause of hematological progress while receiving imatinib. These patients hadNew York Heart Association (NYHA) functional class II dyspnea with elevated rightventricular systolic pressure (RVSP), which progressed under dasatinib treatment. After dasatinib treatment was discontinued, subjective symptoms were improved toNYHA functional class I and the follow-up transthoracic Doppler echocardiographyshowed improved RVSP. Treatment with an alternate tyrosine kinase inhibitor wasinitiated and had been continued without development of dyspnea or elevation ofRVSP. This report suggests that dasatinib can cause the reversible PAH, therefore,routine cardiopulmonary evaluation before and during treatment with dasatinib maybe needed in CML patients with clinical manifestations.
참고문헌 (15)
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