Dasatinib-Induced Pulmonary Arterial Hypertension
Evan Orlikow1, Jason Weatherald2, Naushad Hirani3
1Section of Respirology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
The Canadian Journal of Cardiology
|October 9, 2019
Summary
Dasatinib treatment can cause severe pulmonary arterial hypertension (PAH) in patients with underlying heart conditions. Discontinuing dasatinib therapy led to complete PAH reversal in this case.
Area of Science:
- Cardiology
- Hematology
- Pharmacology
Background:
- Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm.
- Dasatinib is a tyrosine kinase inhibitor used to treat CML.
- Pulmonary arterial hypertension (PAH) is a severe condition characterized by high blood pressure in the lung arteries.
Observation:
- A 73-year-old woman with CML developed severe PAH and pleural effusions after dasatinib treatment.
- Workup revealed partial anomalous pulmonary venous connection and a sinus venosus atrial septal defect, suggesting predisposition.
- The patient's PAH resolved completely upon discontinuation of dasatinib.
Findings:
- Dasatinib can induce severe pulmonary arterial hypertension.
- Pre-existing cardiovascular anomalies may increase susceptibility to dasatinib-induced PAH.
- Cessation of dasatinib is an effective treatment for this drug-induced condition.
Implications:
- This case underscores the importance of monitoring for PAH in CML patients treated with dasatinib, especially those with congenital heart defects.
- Physicians should consider dasatinib's potential cardiotoxicity and assess patients for underlying pulmonary vascular disease risk factors.
- Early recognition and drug withdrawal can lead to complete recovery from dasatinib-induced PAH.
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