Dasatinib Induced Avascular Necrosis of Femoral Head in Adult Patient with Chronic Myeloid Leukemia.
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia (Ph) chromosome resulting from the reciprocal translocation t(9;22)(q34;q11). The molecular consequence of this translocation is the generation of the BCR-ABL fusion gene, which encodes a constitutively active protein tyrosine kinase. The oncogenic protein tyrosine kinase, which is located in the cytoplasm, is responsible for the leukemia phenotype through the constitutive activation of multiple signaling pathways involved in the cell cycle and in adhesion and apoptosis. Avascular necrosis of the femoral head (AVNFH) is not a specific disease. It occurs as a complication or secondary to various causes. These conditions probably lead to impaired blood supply to the femoral head. The diagnosis of AVNFH is based on clinical findings and is supported by specific radiological manifestations. We reported a case of a 34-year-old Sudanese female with CML who developed AVNFH after receiving dasatinib as a second-line therapy. Though the mechanism by which dasatinib can cause avascular necrosis (AVN) is not clear, it can be postulated because of microcirculatory obstruction of the femoral head. To the best of our knowledge and after extensive literature search, this is the first reported case of AVNFH induced by dasatinib in a patient with CML.
National Center for Cancer Care and Research, Department of Hematology and BMT, Hamad Medical Corporation, Doha, Qatar.
Mohamed A
MA
Yassin
Department of Radiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Abbas H
AH
Moustafa
National Center for Cancer Care and Research, Department of Nursing, Hamad Medical Corporation, Doha, Qatar.
Abdulqadir J
AJ
Nashwan
Department of Pediatrics, University of Alexandria, Doha, Qatar.
Ashraf T
AT
Soliman
National Center for Cancer Care and Research, Department of Hematology and BMT, Hamad Medical Corporation, Doha, Qatar.
Hatim
H
El Derhoubi
National Center for Cancer Care and Research, Department of Hematology and BMT, Hamad Medical Corporation, Doha, Qatar.
Shehab F
SF
Mohamed
National Center for Cancer Care and Research, Department of Hematology and BMT, Hamad Medical Corporation, Doha, Qatar.
Deena S
DS
Mudawi
National Center for Cancer Care and Research, Department of Hematology and BMT, Hamad Medical Corporation, Doha, Qatar.
Sarah
S
ELkourashy
National Center for Cancer Care and Research, Department of Nursing, Hamad Medical Corporation, Doha, Qatar.
Deena-Raiza
DR
Asaari
National Center for Cancer Care and Research, Department of Nursing, Hamad Medical Corporation, Doha, Qatar.
Hope-Love G
HL
Gutierrez
National Center for Cancer Care and Research, Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar.
Radwa M
RM
Hussein
National Center for Cancer Care and Research, Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar.
Mohamed
M
Al Musharraf
Department of Pathology, Al-Azhar University, Cairo, Egypt.
Samah
S
Kohla
Orthopedic and Musculoskeletal Oncology, Hamad Medical Corporation, Doha, Qatar.
Ahmed
A
Elsayed
Qatar Medical Genetic Center, Hamad Medical Corporation, Doha, Qatar.
Nader
N
Al-Dewik
CML; avascular necrosis of the femoral head (AVNFH); dasatinib