Sujie Tang1, Hao Xiong2*,
Zhi Chen2, Li Yang2, Ming
Sun2, Wenjie Lu2, Zhuo
Wang2, Fang Tao2, Min
Wu2, Linlin Luo1, Zuofeng
Li3
1School of Medicine of Jianghan University, Wuhan
430056, Hubei Province, PRC
2Division of
Pediatric Hematology and Oncology,Wuhan Children’s Hospital (Wuhan
Maternal and Child Healthcare Hospital), Wuhan 430016, Hubei Province,
PRC
3Medical College
of Wuhan University of Science and Technology, Wuhan, 430081, Hubei
Province, China.
*Corresponding author:
Hao Xiong, MD, Division of Pediatric Hematology and Oncology,Wuhan
Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital),
Wuhan 430016, Hubei Province, PRC, Email:225847481@qq.com
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.
Keywords: Dasatinib, pulmonary arterial hypertension, acute
lymphoblastic leukemia, Philadelphia chromosome, childhood