Dasatinib tedavisine bağlı eşzamanlı gelişen plevral ve perikardiyal efüzyon: Olgu sunumu
Dasatinib, imatinib tedavisine hematolojik ve/veya sitogenetik yanıt alınamayan yeni tanı almış Philadelphia Kromozomu (Ph1) pozitif kronik miyeloid lösemi (KML) tedavisinde kanıtlanmış potent bir tirozin kinaz inhibitörüdür. Dasatinib tedavisine bağlı plevral ve perikardiyal efüzyonlar ilacın başlanmasından genellikle 5-30 hafta sonra görülebilmekle beraber, herhangi bir zaman aralığında da gelişebilir. Plevral efüzyonlar sıklıkla bilateral ve eksüda karakterinde olup lenfosit hücre hakimiyeti çoğunlukla gözlenmektedir. Dasatinib tedavisine devam edilmemesi durumunda ortaya çıkan yan etkilerin büyük oranda gerilediği gözlemlenmiştir. Bu yazıda, dasatinib tedavisi altında New York Heart Association (NYHA) fonksiyonel clas III dispne ile başvuran, eş zamanlı plevral ve perikardiyal efüzyon gelişen, literatürde nadir gözlemlenen bir vaka sunuldu. Bu olguyu sunma amacımız, Dasatinib tedavisinde eşzamanlı plevral ve perikardiyal efüzyon gelişiminin nadir görülmesi, tedavi öncesi ve süresince yapılacak aralıklı kardiyopulmoner değerlendirmenin KML hastalarının takibindeki önemini bir kez daha vurgulamaktır.
Simultaneously occurred pleural and pericardial effusion related to dasatinib treatment: A case report
Dasatinib is a proven potent tyrosine kinase inhibitor which is used in the newly diagnosed Philadelphia Chromosome (Ph1) positive chronic myeloid leukemia (CML) treatment when there is no hematological and/or cytogenetic response to imatinib treatment. Pleural and pericardial effusions due to dasatinib therapy may be seen 5 to 30 weeks after the onset of the treatment, but may also develop at any time interval. Pleural effusions are frequently bilateral and exudative, and lymphocyte cell dominance is often observed . It has been observed that when dasatinib treatment is stopped, the side effects which occurred with the treatment are greatly regressed. In this article, we present a case with New York Heart Association (NYHA) functional class III dyspnea under the treatment of dasatinib and developed simultaneous pleural and pericardial effusion, which is rare in the literature. Our aim of presenting this case is to emphasize once again the rarity of simultaneous pleural and pericardial effusion development in dasatinib therapy, and the importance of intermittent cardiopulmonary evaluation before and during the treatment of CML patients.
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