Change of right ventricular systolic pressure can indicate dasatinib‐induced pulmonary arterial hypertension in chronic myeloid leukemia

Abstract

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cancer Therapy-Associated Pulmonary Hypertension and Right Ventricular Dysfunction: Etiologies and Prognostic Implications

“…Dasatinib is a TKI used in the treatment of CML or Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) [ 53 ]. The development of PH, particularly PAH, has been described among patients with CML or Philadelphia chromosome-positive ALL treated with dasatinib with an incidence of 0.45% to 12%, depending on the modality used for PH diagnosis and definition of PH [ 54 , 55 , 56 ]. In a randomized clinical trial of patients with CML treated with dasatinib compared with imatinib, patients on dasatinib had a 5% prevalence of PH compared with 0.4% of patients on imatinib [ 57 ].…”

“…In a randomized clinical trial of patients with CML treated with dasatinib compared with imatinib, patients on dasatinib had a 5% prevalence of PH compared with 0.4% of patients on imatinib [ 57 ]. A retrospective study of 451 CML patients on dasatinib who underwent transthoracic echocardiography (TTE) found that 56 (12%) of patients had an elevated right ventricular systolic pressure (RVSP) of 40 mmHg [ 55 ]. In another of study of 243 patients treated with dasatinib, 12.3% had RVSP 40 mmHg after a median follow-up of 27 months [ 58 ].…”

“…Dasatinib-associated PH appears to be reversible in some patients after cessation of dasatinib [ 59 , 60 , 61 ]. In one study of the 56 patients with elevated RVSP on TTE after dasatinib initiation, 97% of patients had a decrease or normalization of RVSP after cessation of dasatinib [ 55 ]. Also in a registry of RHC-confirmed cases of dasatinib-associated PAH, drug cessation was associated with significant improvements in New York Heart Association (NYHA) class, walk distance, and PVR; however, PAH persisted in 37% of patients [ 62 ].…”

Right ventricular dysfunction in cancer patients; Is it real or dilemma? A narrative review

“…Progressive increase in pulmonary vascular resistance could be the cause of RV failure [44]. Gradual increase in Rv Systolic Pressure (RVSP) may be induced by dasatinib and trans-thoracic echocardiography (TTE) could be a good monitoring tool for early detection of Dasatinib induced PAH [45].…”