+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy



Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy



Case Reports in Cardiology 2018: 3895197



Pulmonary arterial hypertension (PAH) is a rare complication of dasatinib that was approved as a first-line therapy for chronic myelocytic leukemia (CML). A 24-year-old man presenting dyspnea at rest and leg edema was admitted to our hospital. He had been diagnosed with CML and prescribed dasatinib for 4 years. Chest X-ray showed significant bilateral pleural effusion and heart enlargement. Echocardiography revealed interventricular septal compression and elevated peak tricuspid regurgitation pressure gradient of 66.7 mmHg indicating severe pulmonary hypertension. After the other specific diseases to provoke PAH were excluded, he was diagnosed with dasatinib-induced PAH. Despite discontinuation of dasatinib and intravenous administration of diuretic for two weeks, World Health Organization (WHO) functional class was still II and mean pulmonary arterial pressure (PAP) was high at 37 mmHg. Therefore, we administered sildenafil and bosentan together as an upfront combination therapy three weeks after dasatinib discontinuation. Six months later, his symptoms improved to WHO functional class I and mean PAP was decreased to 31 mmHg. Although PAH is a rare complication of dasatinib, symptomatic patients prescribed with dasatinib should have an echocardiogram for PAH screening. Moreover, the upfront combination therapy would be a useful option for symptomatic patients after discontinuation of dasatinib.

(PDF emailed within 0-6 h: $19.90)

Accession: 057523079

Download citation: RISBibTeXText

PMID: 29888010

DOI: 10.1155/2018/3895197


Related references

Upfront triple combination therapy-induced pulmonary edema in a case of pulmonary arterial hypertension associated with Sjogren's syndrome. Respiratory Medicine Case Reports 23: 55-59, 2017

Predicting the Need for Upfront Combination Therapy in Pulmonary Arterial Hypertension. Journal of Cardiovascular Pharmacology and Therapeutics 20(4): 395-400, 2016

Combination targeted pulmonary hypertension therapy in the resolution of Dasatinib-associated pulmonary arterial hypertension. Pulmonary Circulation 7(4): 803-807, 2017

Upfront combination therapy reduces right ventricular volumes in pulmonary arterial hypertension. European Respiratory Journal 49(6), 2018

Upfront triple combination therapy in pulmonary arterial hypertension: a pilot study. European Respiratory Journal 43(6): 1691-1697, 2015

Upfront combination therapy: does the AMBITION study herald a new era in the treatment of pulmonary arterial hypertension?. Thorax 71(2): 107-109, 2016

Efficacy of oral triple upfront combination therapy (long-acting prostacyclin analogue, endothelin receptor antagonist, phosphodiesterase 5 inhibitor) in the patients with idiopathic/heritable pulmonary arterial hypertension. Life Sciences 93(25-26): E48-E49, 2013

The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients: cardiac magnetic resonance feature tracking study. Pulmonary Circulation 8(1): 2045893217748307, 2017

Pulmonary arterial hypertension in patients treated by dasatinib. Circulation 125(17): 2128-2137, 2012

EXPRESS: Clinical and Hemodynamic Benefit of Macitentan and Riociguat Upfront Combination in Patients with Pulmonary Arterial Hypertension. Pulmonary Circulation 2019: 2045894019826944-2045894019826944, 2019

Perioperative management with upfront combination therapy in a patient exhibiting idiopathic pulmonary hypertension with central pulmonary thrombosis. Internal Medicine 53(7): 777-781, 2015

Pulmonary arterial hypertension in a patient treated with dasatinib: a case report. Journal of Medical Case Reports 11(1): 362, 2018

Dasatinib-induced pulmonary arterial hypertension. British Journal of Clinical Pharmacology 84(5): 835-845, 2018

Upfront triple therapy for pulmonary arterial hypertension: is three a crowd or critical mass?. European Respiratory Journal 43(6): 1556-1559, 2015

First histopathological evidence of irreversible pulmonary vascular disease in dasatinib-induced pulmonary arterial hypertension. European Respiratory Journal 51(3), 2018