A case of long-term dasatinib-induced proteinuria and glomerular injury

Koinuma, Kana; Sakairi, Toru; Watanabe, Yoshikazu; IIzuka, Azusa; Watanabe, Mitsuharu; Hamatani, Hiroko; Nakasatomi, Masao; Ishizaki, Takuma; Ikeuchi, Hidekazu; Kaneko, Yoriaki; Hiromura, Keiju

doi:10.1007/s13730-020-00484-8

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…Biopsy specimens obtained in some cases of dasatinib-associated nephrotic proteinuria [ 31 , 32 , 34 , 35 , 37 ] revealed podocytopathy (minimal change disease), characterized by the effacement of the podocyte foot processes at electron microscopy analysis, as in our patient ( Figure 2 ). Podocytes are crucial for the establishment of the blood-urine filtration barrier in glomeruli, and the injury of them causes proteinuria.…”

Section: Discussionsupporting

confidence: 61%

“…To our knowledge, including the present one there are nine case reports of nephrotic syndrome caused by dasatinib reported in the scientific literature. Three cases affected children [ 31 , 32 , 33 ], and the remainder adults [ 30 , 34 , 35 , 36 , 37 ]. Nephrotic proteinuria developed after a duration of dasatinib administration ranging from 2 weeks [ 30 ] to 2 years [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Three cases affected children [ 31 , 32 , 33 ], and the remainder adults [ 30 , 34 , 35 , 36 , 37 ]. Nephrotic proteinuria developed after a duration of dasatinib administration ranging from 2 weeks [ 30 ] to 2 years [ 37 ]. Dose reduction [ 30 ] or the discontinuation [ 31 , 32 , 33 , 37 ] of dasatinib was associated with an improvement in proteinuria.…”

Section: Discussionmentioning

confidence: 99%

“…Nephrotic proteinuria developed after a duration of dasatinib administration ranging from 2 weeks [ 30 ] to 2 years [ 37 ]. Dose reduction [ 30 ] or the discontinuation [ 31 , 32 , 33 , 37 ] of dasatinib was associated with an improvement in proteinuria. Switching to a first-generation TKI such as imatinib [ 35 , 36 ] or nilotinib [ 34 ], or to the new second-generation TKI bosutinib [ 37 ], also proved an effective strategy.…”

Section: Discussionmentioning

confidence: 99%

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Nephrotoxicity Associated with Novel Anticancer Agents (Aflibercept, Dasatinib, Nivolumab): Case Series and Nephrological Considerations

Piscitani

Sirolli

Liberato

et al. 2020

IJMS

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Cancer patients have an incidence of about 60% kidney disease development and are at elevated risk of acute renal damage. Kidney disease in these patients is frequently associated with nephrotoxicity from the ongoing oncological treatment. New anticancer therapeutic strategies, such as targeted therapies and immunotherapies, offer substantial benefits in the treatment of many neoplasms. However, their use is associated with significant nephrotoxicity, which qualitatively differs from that seen with traditional cytotoxic chemotherapy, while the underlying mechanisms are complex and still to be clearly defined. Nephrologists need to be knowledgeable about the array of such renal toxicities for effective collaboration with the oncologist in the prevention and management of kidney involvement. Renal adverse effects may range from asymptomatic proteinuria to renal failure, and their prompt identification and timely treatment is essential for optimal and safe care of the patient. In this article, after presenting clinical cases we discuss the differing renal toxicity of three novel anticancer agents (aflibercept, dasatinib, and nivolumab) and possible measures to counter it.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Nephrotoxicity Associated with Novel Anticancer Agents (Aflibercept, Dasatinib, Nivolumab): Case Series and Nephrological Considerations

Piscitani

Sirolli

Liberato

et al. 2020

IJMS

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“…In patients treated with TKI, such as imatinib, age and co-morbidities of hypertension and diabetes mellitus have been identified as risk factors of chronic kidney disease (CKD) [4]. In addition, some studies have reported the development nephrotic syndrome or proteinuria in patients treated with dasatinib [5,6].…”

Section: Introductionmentioning

confidence: 99%

Is higher lymphocyte count a potential strategy for preventing chronic kidney disease in patients receiving long-term dasatinib treatment?

Iizuka¹,

Kato²,

Usuki³

2023

J Pharm Health Care Sci

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Background Dasatinib, which is used to treat treating chronic myeloid leukemia, induces increases in blood lymphocytes during the treatment. In addition, neutrophil–lymphocyte count ratio (NLR) is associated with the related to development of chronic kidney disease (CKD). However, it has not been reported whether development of CKD during long-term dasatinib treatment is related to lymphocyte count or NLR. This study aimed to reveal the relationship between CKD and lymphocyte count or NLR during long-term dasatinib treatment. Methods A retrospective study was conducted in patients treated with dasatinib for 6 months or longer. Risk factors for CKD development were explored using multivariate analysis. Changes in maximal lymphocyte count and NLR over time were examined separately. Results A total of 33 patients in CKD group (n = 8) and No CKD group (n = 25) who received dasatinib were enrolled. In univariate analysis, significant differences between the groups were observed in maximal lymphocyte count, lymphocytosis, age, and estimated glomerular filtration rate at baseline. As the factor independently associated with the development of CKD, maximal lymphocyte count (odds ratio 0.999, 95% confidence interval: 0.999–1.000, p = 0.033) was identified. In this analysis, age had borderline significance (odds ratio 1.073, 95% CI: 0.999–1.153, p = 0.054)]. After 6 months of dasatinib therapy, lymphocyte count was significantly lower in CKD group [median (range), 2184 (878‒3444)/μL] than in the No CKD group [3501 (966‒7888)/μL] (p = 0.020). However, no significant difference in lymphocyte count was observed between the groups at the last follow-up. During the study period, the median NLR in the No CKD group fluctuated between 1.11 and 1.42, and median NLR in CKD group was increased from 1.13 to 2.24 between after 6 months of dasatinib therapy and the last follow-up. Conclusions The development of CKD during dasatinib therapy was associated with lower maximal lymphocyte counts. In contrast, the higher levels of lymphocytes induced during dasatinib treatment may prevent CKD progression.

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Clinical features, diagnosis, and management of dasatinib-induced nephrotic syndrome

Fang

et al. 2022

Invest New Drugs

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A case of long-term dasatinib-induced proteinuria and glomerular injury

Cited by 8 publications

References 20 publications

Nephrotoxicity Associated with Novel Anticancer Agents (Aflibercept, Dasatinib, Nivolumab): Case Series and Nephrological Considerations

Nephrotoxicity Associated with Novel Anticancer Agents (Aflibercept, Dasatinib, Nivolumab): Case Series and Nephrological Considerations

Is higher lymphocyte count a potential strategy for preventing chronic kidney disease in patients receiving long-term dasatinib treatment?

Clinical features, diagnosis, and management of dasatinib-induced nephrotic syndrome

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