title: [Clinical profiles of 7 patients with chronic myelogenous leukemia or Philadelphia chromosome-positive acute lymphoblastic leukemia treated with dasatinib].
abstract: We retrospectively analyzed the clinical outcome of dasatinib in 7 patients with chronic myelogenous leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) resistant or intolerant to imatinib. Three patients with chronic phase CML and two patients with Ph+ALL achieved major molecular response, however, two CML patients in accelerated phase (AP)/blast crisis (BC), did not. Grade> or =3 pancytopenia was seen in four patients. Among these, two AP/BC-CML patients required interruption/or dose reduction of dasatinib. As for nonhematologic adverse events, pleural effusion was seen in one patient and cytomegalovirus (CMV) colitis was observed in two patients. No patients who had been intolerant to imatinib experienced the same nonhematologic toxicity following treatment with dasatinib. We identified three patients who developed peripheral lymphocytosis, identified as natural killer cells or cytotoxic T-cells based on their large granular lymphocyte (LGL) morphologies and immunophenotypic profiles, out of six patients receiving dasatinib therapy. All three cases that developed LGL lymphocytosis achieved optimal molecular response, two of the patients, however, had pleural effusion and CMV colitis, respectively. Dasatinib inhibits off-target kinases, which may result in unexpected drug responses.
authors.affiliation: Leukemia Research Center, Saiseikai Maebashi Hospital, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hoshino
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tahara
authors.forename: Kohta
authors.initials: K
authors.lastname: Miyawaki
authors.forename: Nahoko
authors.initials: N
authors.lastname: Hatsumi
authors.forename: Satoru
authors.initials: S
authors.lastname: Takada
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyawaki
authors.forename: Tohru
authors.initials: T
authors.lastname: Sakura
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003092:Colitis / Q000139:chemically induced / Q000821:virology; D003586:Cytomegalovirus Infections; D000069439:Dasatinib; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008875:Middle Aged; D010677:Philadelphia Chromosome; D010996:Pleural Effusion / Q000139:chemically induced; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013844:Thiazoles / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D011743:Pyrimidines; D013844:Thiazoles; D000069439:Dasatinib