title: Dasatinib followed by second allogeneic hematopoietic stem cell transplantation for relapse of Philadelphia chromosome-positive acute lymphoblastic leukemia after the first transplantation.
abstract: Although allogeneic hematopoietic stem cell transplantation (HSCT) is an established treatment for Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL), the prognosis of patients who relapse after allogeneic HSCT has been extremely poor. Dasatinib, a second-generation tyrosine kinase inhibitor, is a promising agent for the treatment of Ph-ALL. We report on a Ph-ALL patient who relapsed early after the first allogeneic HSCT, but achieved complete molecular remission with dasatinib alone. She remains in molecular remission 12 months after the second allogeneic HSCT. Dasatinib was generally well tolerated, but she developed myalgia, nausea and positive cytomegalovirus antigenemia. In addition, sudden-onset bloody diarrhea was observed 10 days after the second HSCT, which was possibly associated with the use of dasatinib in addition to the effect of the conditioning regimen and graft-versus-host disease. In conclusion, dasatinib is an effective agent for Ph-ALL with a poor prognosis, but may be associated with specific adverse events including opportunistic infection and gastrointestinal bleeding.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ishida
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako
authors.forename: Kumi
authors.initials: K
authors.lastname: Oshima
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000293:Adolescent; D000069439:Dasatinib; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000517:prevention & control* / Q000601:surgery; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D014184:Transplantation, Homologous
chemical_list: D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000069439:Dasatinib
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