Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections
Blast crisis (BC) continues to be the major challenge in the treatment of chronic myeloid leukemia. Best results have been observed in a few patients who were successfully transplanted after returning to chronic phase. Recent studies focus on the combination of chemotherapy with imatinib, but result...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2020/8867461 |
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| author | Jorge Labrador Gerardo J. Hermida Rodolfo Alvarez Victor Anso Pilar de Vicente Mercedes Goñi Tomas Jose Gonzalez-Lopez |
| author_facet | Jorge Labrador Gerardo J. Hermida Rodolfo Alvarez Victor Anso Pilar de Vicente Mercedes Goñi Tomas Jose Gonzalez-Lopez |
| author_sort | Jorge Labrador |
| collection | DOAJ |
| description | Blast crisis (BC) continues to be the major challenge in the treatment of chronic myeloid leukemia. Best results have been observed in a few patients who were successfully transplanted after returning to chronic phase. Recent studies focus on the combination of chemotherapy with imatinib, but results remain unsatisfactory. Since dasatinib induces deeper and faster responses, a reasonable strategy might be to combine it with chemotherapy, taking into account the alterations in T-cell response induced by dasatinib. However, there are no published studies or case reports supporting the use of dasatinib as first line treatment for initial myeloid BC, and very little is known about infectious complications associated with this drug. Based on this, we present the case of a patient diagnosed with an initial nonlymphoid phenotype BC, who achieved molecular response (MR4.5) with dasatinib and FLAG-IDA, but he suffered a pulmonary aspergillosis, CMV infection, and a CMV reactivation, prior to an allogeneic hematopoietic stem cell transplantation (HSCT). In conclusion, dasatinib and FLAG-IDA is an effective therapy for initial BC. However, a warning call is needed owing to the high risk of opportunistic infections, such as CMV. |
| format | Article |
| id | doaj-art-2b960609bf5243d0b8e1eabe8acbdc77 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-2b960609bf5243d0b8e1eabe8acbdc772025-02-03T06:43:30ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/88674618867461Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic InfectionsJorge Labrador0Gerardo J. Hermida1Rodolfo Alvarez2Victor Anso3Pilar de Vicente4Mercedes Goñi5Tomas Jose Gonzalez-Lopez6Department of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainDepartment of Hematology, University Hospital of Burgos, Burgos, SpainBlast crisis (BC) continues to be the major challenge in the treatment of chronic myeloid leukemia. Best results have been observed in a few patients who were successfully transplanted after returning to chronic phase. Recent studies focus on the combination of chemotherapy with imatinib, but results remain unsatisfactory. Since dasatinib induces deeper and faster responses, a reasonable strategy might be to combine it with chemotherapy, taking into account the alterations in T-cell response induced by dasatinib. However, there are no published studies or case reports supporting the use of dasatinib as first line treatment for initial myeloid BC, and very little is known about infectious complications associated with this drug. Based on this, we present the case of a patient diagnosed with an initial nonlymphoid phenotype BC, who achieved molecular response (MR4.5) with dasatinib and FLAG-IDA, but he suffered a pulmonary aspergillosis, CMV infection, and a CMV reactivation, prior to an allogeneic hematopoietic stem cell transplantation (HSCT). In conclusion, dasatinib and FLAG-IDA is an effective therapy for initial BC. However, a warning call is needed owing to the high risk of opportunistic infections, such as CMV.http://dx.doi.org/10.1155/2020/8867461 |
| spellingShingle | Jorge Labrador Gerardo J. Hermida Rodolfo Alvarez Victor Anso Pilar de Vicente Mercedes Goñi Tomas Jose Gonzalez-Lopez Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections Case Reports in Hematology |
| title | Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections |
| title_full | Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections |
| title_fullStr | Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections |
| title_full_unstemmed | Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections |
| title_short | Dasatinib and FLAG-IDA Is an Effective Therapy for Initial Myeloid Blast Crisis but Involves a High Risk of Opportunistic Infections |
| title_sort | dasatinib and flag ida is an effective therapy for initial myeloid blast crisis but involves a high risk of opportunistic infections |
| url | http://dx.doi.org/10.1155/2020/8867461 |
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