Abstract
Dasatinib is an effective treatment option for patients diagnosed with Philadelphia chromosome positive chronic myeloid leukemia and who are non-responsive or intolerant to imatinib treatment. Dasatinib, however, is associated with various adverse effects and on rare occasions, may cause hemorrhagic colitis. We report the case of a 68-year-old male patient with dasatinib-induced hemorrhagic colitis, the first such case in Korea. Endoscopic biopsy of the transverse colon demonstrated non-specific inflammatory changes only. Cessation of dasatinib led to the resolution of symptoms, while reintroduction of the therapy led to the recurrence of his bloody diarrhea. To clarify the association between dasatinib and hemorrhagic colitis, the lymphocyte transformation test (LTT) was performed. The LTT result sustained a relatively high proliferation activity in the affected patient compared with almost no proliferation activity in normal control.
This is a preview of subscription content, log in via an institution to check access.
References
Talpaz M, Shah NP, Kantarjian H, Donato N, Nicoll J, Paquette R et al (2006) Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias. N Engl J Med 354:2531–2541
Apperley JF, Cortes JE, Kim D-W, Roy L, Roboz GJ, Rosti G et al (2009) Dasatinib in the treatment of chronic myeloid leukemia in accelerated phase after imatinib failure: the START a trial. J Clin Oncol 27:3472–3479
Uday RP (2011) Leukemia. Demos Medical Pub, New York
Carpiuc KT, Stephens JM, Liou SY, Botteman MF. Incidence of grade 3/4 adverse events in imatinib resistant/intolerant chronic phase CML (CP-CML): A comparison of nilotinib and dasatinib. 2007; 25. http://meeting.ascopubs.org/cgi/content/abstract/25/18_suppl/17501
Shimokaze T, Mitsui T, Takeda H, Kawakami T, Arai T, Ito M et al (2009) Severe hemorrhagic colitis caused by dasatinib in Philadelphia chromosome-positive acute lymphoblastic leukemia. Pediatr Hematol Oncol 26:448–453
Erkut M, Erkut N, Ersoz S, Arslan M, Sonmez M (2010) A case of acute colitis with severe rectal bleeding in a patient with chronic myeloid leukemia after dasatinib use. Acta Haematol 123:205–206
Sunami Y, Sato E, Ichikawa K, Yasuda H, Komatsu N (2011) Hemorrhagic colitis caused by dasatinib following cytomegalovirus enterocolitis in a patient with chronic myelogenous leukemia in the second chronic phase. Rinshō Ketsueki Jpn J Clin Hematol 52:282–286
Kim M-H, Shim E-J, Jung J-W, Sohn S-W, Kang H-R (2012) A case of allopurinol-induced fixed drug eruption confirmed with a lymphocyte transformation test. Allergy Asthma Immunol Res 4:309–310
Saglio G, Kim D-W, Issaragrisil S, le Coutre P, Etienne G, Lobo C et al (2010) Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med 362:2251–2259
Ohanian M, Cortes J, Kantarjian H, Jabbour E (2012) Tyrosine kinase inhibitors in acute and chronic leukemias. Expert Opin Pharmacother 13:927–938
Ravandi F (2011) Managing Philadelphia chromosome-positive acute lymphoblastic leukemia: role of tyrosine kinase inhibitors. Clin Lymphoma Myeloma Leuk 11:198–203
Krauth M-T, Herndlhofer S, Schmook M-T, Mitterbauer-Hohendanner G, Schlogl E, Valent P (2011) Extensive pleural and pericardial effusion in chronic myeloid leukemia during treatment with dasatinib at 100 mg or 50 mg daily. Haematologica 96:163–166
Matsushita M, Nishihara H, Nishiyama R, Kobayashi Y (2007) Acute hemorrhagic colitis associated with oral administration of oseltamivir for the treatment of influenza A. J Infect Chemother 13:267–269
Meyboom RH, Hekster YA, Egberts AC, Gribnau FW, Edwards IR (1997) Causal or casual? The role of causality assessment in pharmacovigilance. Drug Saf 17:374–389
Meyboom RHB, Royer RJ (1992) Causality classification at pharmacovigilance centres in the european community. Pharmacoepidemiol Drug Saf 1:87–97
Pichler WJ (2003) Delayed drug hypersensitivity reactions. Ann Intern Med 139:683–693
Yawalkar N, Egli F, Hari Y, Nievergelt H, Braathen LR, Pichler WJ (2000) Infiltration of cytotoxic T cells in drug-induced cutaneous eruptions. Clin Exp Allergy 30:847–855
Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T (2007) Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption. Allergy 62:1439–1444
Acknowledgments
This research was supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF), as funded by the Ministry of Education, Science and Technology (No. 2009-0072738).
Author information
Authors and Affiliations
Corresponding author
Additional information
Hongkeun Ahn and Ji Eun Kwon are contributed equally to this paper.
Rights and permissions
About this article
Cite this article
Ahn, H., Kwon, J.E., Sohn, SW. et al. A Case of Dasatinib-Induced Hemorrhagic Colitis Diagnosed by the Lymphocyte Transformation Test in a Chronic Myeloid Leukemia Patient. Indian J Hematol Blood Transfus 32 (Suppl 1), 96–99 (2016). https://doi.org/10.1007/s12288-015-0528-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-015-0528-z