Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy
Pulmonary arterial hypertension (PAH) is a rare complication of dasatinib that was approved as a first-line therapy for chronic myelocytic leukemia (CML). A 24-year-old man presenting dyspnea at rest and leg edema was admitted to our hospital. He had been diagnosed with CML and prescribed dasatinib...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2018/3895197 |
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| author | Makoto Nishimori Tomoyuki Honjo Kenji Kaihotsu Naohiko Sone Sachiko Yoshikawa Junichi Imanishi Kazuhiko Nakayama Noriaki Emoto Masanori Iwahashi |
| author_facet | Makoto Nishimori Tomoyuki Honjo Kenji Kaihotsu Naohiko Sone Sachiko Yoshikawa Junichi Imanishi Kazuhiko Nakayama Noriaki Emoto Masanori Iwahashi |
| author_sort | Makoto Nishimori |
| collection | DOAJ |
| description | Pulmonary arterial hypertension (PAH) is a rare complication of dasatinib that was approved as a first-line therapy for chronic myelocytic leukemia (CML). A 24-year-old man presenting dyspnea at rest and leg edema was admitted to our hospital. He had been diagnosed with CML and prescribed dasatinib for 4 years. Chest X-ray showed significant bilateral pleural effusion and heart enlargement. Echocardiography revealed interventricular septal compression and elevated peak tricuspid regurgitation pressure gradient of 66.7 mmHg indicating severe pulmonary hypertension. After the other specific diseases to provoke PAH were excluded, he was diagnosed with dasatinib-induced PAH. Despite discontinuation of dasatinib and intravenous administration of diuretic for two weeks, World Health Organization (WHO) functional class was still II and mean pulmonary arterial pressure (PAP) was high at 37 mmHg. Therefore, we administered sildenafil and bosentan together as an upfront combination therapy three weeks after dasatinib discontinuation. Six months later, his symptoms improved to WHO functional class I and mean PAP was decreased to 31 mmHg. Although PAH is a rare complication of dasatinib, symptomatic patients prescribed with dasatinib should have an echocardiogram for PAH screening. Moreover, the upfront combination therapy would be a useful option for symptomatic patients after discontinuation of dasatinib. |
| format | Article |
| id | doaj-art-be1ae195cd80498b97c27f01b950c045 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-be1ae195cd80498b97c27f01b950c0452025-02-03T05:53:05ZengWileyCase Reports in Cardiology2090-64042090-64122018-01-01201810.1155/2018/38951973895197Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination TherapyMakoto Nishimori0Tomoyuki Honjo1Kenji Kaihotsu2Naohiko Sone3Sachiko Yoshikawa4Junichi Imanishi5Kazuhiko Nakayama6Noriaki Emoto7Masanori Iwahashi8Division of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Cardiology, Department of Internal Medicine, Shinko Hospital, Kobe, JapanPulmonary arterial hypertension (PAH) is a rare complication of dasatinib that was approved as a first-line therapy for chronic myelocytic leukemia (CML). A 24-year-old man presenting dyspnea at rest and leg edema was admitted to our hospital. He had been diagnosed with CML and prescribed dasatinib for 4 years. Chest X-ray showed significant bilateral pleural effusion and heart enlargement. Echocardiography revealed interventricular septal compression and elevated peak tricuspid regurgitation pressure gradient of 66.7 mmHg indicating severe pulmonary hypertension. After the other specific diseases to provoke PAH were excluded, he was diagnosed with dasatinib-induced PAH. Despite discontinuation of dasatinib and intravenous administration of diuretic for two weeks, World Health Organization (WHO) functional class was still II and mean pulmonary arterial pressure (PAP) was high at 37 mmHg. Therefore, we administered sildenafil and bosentan together as an upfront combination therapy three weeks after dasatinib discontinuation. Six months later, his symptoms improved to WHO functional class I and mean PAP was decreased to 31 mmHg. Although PAH is a rare complication of dasatinib, symptomatic patients prescribed with dasatinib should have an echocardiogram for PAH screening. Moreover, the upfront combination therapy would be a useful option for symptomatic patients after discontinuation of dasatinib.http://dx.doi.org/10.1155/2018/3895197 |
| spellingShingle | Makoto Nishimori Tomoyuki Honjo Kenji Kaihotsu Naohiko Sone Sachiko Yoshikawa Junichi Imanishi Kazuhiko Nakayama Noriaki Emoto Masanori Iwahashi Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy Case Reports in Cardiology |
| title | Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy |
| title_full | Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy |
| title_fullStr | Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy |
| title_full_unstemmed | Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy |
| title_short | Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy |
| title_sort | dasatinib induced pulmonary arterial hypertension treated with upfront combination therapy |
| url | http://dx.doi.org/10.1155/2018/3895197 |
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