title: Pneumocystis jiroveci pneumonia in patients receiving dasatinib treatment.
abstract: Dasatinib may cause various adverse effects such as myelosuppression and pleural effusion. It is well known that dasatinib may affect cellular immunity, which leads to the subsequent risk of a myriad of infections and viral reactivations, especially cytomegalovirus. Pneumocystis jiroveci pneumonia (PJP) is an opportunistic infection that typically occurs in immunocompromised hosts. Although pneumonia is not uncommon among dasatinib-treated patients, dasatinib-associated PJP has been reported only once in the literature, without a description of the clinical details. We report herein two cases of PJP in patients receiving treatment containing dasatinib. One patient developed PJP at 7 months following dasatinib in combination with chemotherapy for the treatment of acute lymphoblastic leukemia. The other patient developed pleural effusion and PJP at 2 years following dasatinib treatment for chronic myeloid leukemia. Both patients recovered well after management with sulfamethoxazole/trimethoprim. Our experience illustrates that PJP is a potentially important complication of dasatinib-based treatment. Raising clinical awareness is important as prompt diagnosis and timely management are the cornerstones of successful treatment.
authors.affiliation: Division of Hematology-Oncology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan Township, Taoyuan 333, Taiwan; School of Medicine, Chang Gung University, Kweishan Township, Taoyuan Taiwan. Electronic address: doctor.horngchang@gmail.com.
authors.forename: Hung
authors.initials: H
authors.lastname: Chang
authors.affiliation: Division of Hematology-Oncology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan Township, Taoyuan 333, Taiwan.
authors.forename: Yu-Shin
authors.initials: YS
authors.lastname: Hung
authors.affiliation: Division of Hematology-Oncology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan Township, Taoyuan 333, Taiwan.
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chou
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069439:Dasatinib; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000188:drug therapy / Q000209:etiology; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D013844:Thiazoles / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000069439:Dasatinib
keywords: Acute lymphoblastic leukemia; Chronic myeloid leukemia; Dasatinib; Philadelphia chromosome; Pneumocystis jiroveci pneumonia