Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia.
A 56-year-old man being treated for dilated cardiomyopathy presented with epigastralgia. He was diagnosed with ventricular tachycardia and Philadelphia chromosome-positive acute lymphoblastic leukemia. After treating incessant ventricular tachycardia, we commenced induction therapy for leukemia with dasatinib and prednisolone to minimize toxicity towards cardiomyocytes and the cardiac conduction system. Although dasatinib was temporarily withheld because of a recurrence of ventricular tachycardia, we rechallenged dasatinib while using bisoprolol and amiodarone and achieved a complete hematological response three weeks later. Although drug interactions between dasatinib and amiodarone were of concern, the blood concentration of each drug remained within the safe range after concomitant use, and there were no adverse cardiac effects such as QT prolongation after rechallenging dasatinib. Induction therapy with dasatinib and prednisolone may be an acceptable therapeutic option for Philadelphia chromosome-positive acute lymphoblastic leukemia with severe cardiac complications.
Hematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, Japan.
Mitsutaka
0000-0002-0388-3836
M
Nishimoto
Hematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, Japan.
Hirohisa
H
Nakamae
Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, Japan.
Kana
K
Matsumoto
Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, Japan.
Kunihiko
K
Morita
Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, Japan.
Yuki
Y
Koga
Department of Hematology, Osaka General Hospital, West Japan Railway Company, 1-2-22 Matsuzaki-cho, Abeno, Osaka, Japan.
Dai
D
Momose
Hematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, Japan.
Masayuki
M
Hino