Dasatinib-induced pulmonary arterial hypertension in pediatric acute
lymphoblastic leukemia with Philadelphia chromosome: A report of two
cases
Abstract
Background: Long-term oral dasatinib administration can induce
pulmonary arterial hypertension (PAH) in pediatric patients with
Philadelphia chromosome-positive (Ph +) acute
lymphoblastic leukemia (ALL). We describe the findings in two pediatric
cases involving Ph + ALL patients who developed
cardiovascular events such as PAH after dasatinib treatment, and present
a review of the related literature. Case presentation: Two
pediatric patients diagnosed with B-cell ALL ( BCR-ABL P190
fusion gene positive) received conventional chemotherapy and imatinib
simultaneously, which was then changed to dasatinib because of a partial
response. The two patients developed PAH after 18 months and 6 years of
dasatinib therapy. All signs and symptoms improved after immediate
discontinuation of dasatinib and symptomatic treatment.
Conclusions: Pediatric Ph + ALL patients
receiving dasatinib should be carefully monitored for serious
cardiopulmonary and vascular events such as PAH. Development of adverse
reactions should be followed by immediate and permanent discontinuation
of oral dasatinib. Dynamic monitoring by echocardiography is recommended
when administering dasatinib for maintenance therapy.