title: Safe switching from dasatinib to nilotinib after a 1-month off-drug period for persistent pleural effusion in patients with chronic myelogenous leukemia in chronic phase.
abstract: The approval of two new tyrosine kinase (TK) inhibitors, nilotinib and dasatinib, has raised the issue of cross-intolerance. Evaluating the safety of interchanging TK inhibitors is particularly important for patients who are intolerant to one medication but are considered to be sensitive to the other. Available data are limited and it is unclear whether switching between TK inhibitors is possible without an off-drug period. We present two patients with chronic myelogenous leukemia in whom, following the development of symptomatic pleural effusion, medications were safely switched from dasatinib to nilotinib after a 1-month off-drug period. The lymphocytosis and increased large granular lymphocyte count observed during dasatinib treatment also subsided after switching medications.
authors.affiliation: Hematology Division, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo, Tokyo 113-8677, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Nagata
authors.forename: Shiomi
authors.initials: S
authors.lastname: Fukuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001549:Benzamides; D000069439:Dasatinib; D019008:Drug Resistance, Neoplasm; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage; D010996:Pleural Effusion / Q000139:chemically induced*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000068877:Imatinib Mesylate; C498826:nilotinib; D000069439:Dasatinib