目錄/各期文章

內科學誌 -第30卷第2期

病例 
Complete Recovery from Dasatinib-induced Pulmonary Arterial Hypertension after Successful Discontinuation of Tyrosine Kinase Inhibitor in A Case of Chronic Myeloid Leukemia  全文閱讀
161~165 
英文 
Chronic myeloid leukemia、Dasatinib、Pulmonary arterial hypertension、Tyrosine kinase inhibitor 
施恩潔1,2 、宋思賢1,3 、高志平1,4  
國立陽明大學醫學系1 、臺北榮民總醫院教學部內科部2 、臺北榮民總醫院心臟科3 、臺北榮民總醫院血液科4  
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 dasatinibinduced severe PAH and kept complete molecular response without taking other TKIs. Early detection of the adverse effect of dasatinib is important for better outcomes.