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...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/4027908 |
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| author | Mitsutaka Nishimoto Hirohisa Nakamae Kana Matsumoto Kunihiko Morita Yuki Koga Dai Momose Masayuki Hino |
| author_facet | Mitsutaka Nishimoto Hirohisa Nakamae Kana Matsumoto Kunihiko Morita Yuki Koga Dai Momose Masayuki Hino |
| author_sort | Mitsutaka Nishimoto |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-c286e68ab8fb43bd8847a020bb73d006 |
| institution | DOAJ |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-c286e68ab8fb43bd8847a020bb73d0062025-08-20T03:23:15ZengWileyCase Reports in Hematology2090-65602090-65792017-01-01201710.1155/2017/40279084027908Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular TachycardiaMitsutaka Nishimoto0Hirohisa Nakamae1Kana Matsumoto2Kunihiko Morita3Yuki Koga4Dai Momose5Masayuki Hino6Hematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, JapanHematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, JapanDepartment of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women’s College of Liberal Arts, Kodo, Kyotanabe, Kyoto, JapanDepartment of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women’s College of Liberal Arts, Kodo, Kyotanabe, Kyoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, JapanDepartment of Hematology, Osaka General Hospital, West Japan Railway Company, 1-2-22 Matsuzaki-cho, Abeno, Osaka, JapanHematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno, Osaka, JapanA 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.http://dx.doi.org/10.1155/2017/4027908 |
| spellingShingle | Mitsutaka Nishimoto Hirohisa Nakamae Kana Matsumoto Kunihiko Morita Yuki Koga Dai Momose Masayuki Hino Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia Case Reports in Hematology |
| title | Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia |
| title_full | Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia |
| title_fullStr | Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia |
| title_full_unstemmed | Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia |
| title_short | Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia |
| title_sort | dasatinib and prednisolone induction therapy for a case of philadelphia chromosome positive acute lymphoblastic leukemia with dilated cardiomyopathy accompanied by life threatening ventricular tachycardia |
| url | http://dx.doi.org/10.1155/2017/4027908 |
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