Effective Molecular Monitoring and the Proper Management of Pleural Effusion During the First-Line Dasatinib Administration in CML

Abstract

Dasatinib is considered an effective treatment agent in imatinib-resistant and newly diagnosed chronic phase CML patients. Patients receiving dasatinib 100 mg once daily regime suffered significantly fewer thrombocytopenia and pleural effusion events than those receving 70 mg twice daily. Effective molecular monitoring and the proper management of pleural effusion during the first-line dasatinib administration in CML are essential. Pleural effusion may develop any time of the treatment and is easily managed by treatment interruption, dose reduction and supportive therapy. In this article, we intended to assess the rational of managing CML and pleural effusion that successfully managed with dose reduction and supportive care.Keywords: Dasatinib, First-line therapy, Chronic myeloid leukemia, Pleural effusion ÖZET Kronik Myelositier Lösemide Birinci Basamak Tedavi S›ras›nda Oluflan Plevral Efüzyonun Yönetimi ve Etkin Moleküler ‹zlemDasatinib, imatinibe dirençli ve yeni tan› alm›fl kronik faz KML hastalar›nda etkin bir tedavi ajan› olarak düflünülmektedir. Günde 100 mg tek doz dasatinib tedavisi alan hastalar›n günde 70 mg iki kez tedavisi alanlara göre anlaml› oranda daha düflük trombositopeni ve plevral efüzyon gelifltirdikleri gösterilmifltir. KML'de moleküler monitörizasyonun dikkatli yap›lmas› ve ilk s›ra dasatinib verilen hastalarda plevral effüzyonun yönetilmesi büyük önem tafl›maktad›r. Plevral efüzyonun dasatinib tedavisinin herhangi bir zaman›nda ortaya ç›kabilmekte ve doza ara verme, doz azaltma, ve destek tedaviler ile kolayl›kla yönetilebilmektedir. Bu çal›flmada, KML ve plevral efüzyonun baflar›yla yönetimine iliflkin moleküler yöntemler araflt›r›lacakt›r.Anahtar Kelimeler: Dasatinib, ‹lk-basamak tedavi, Kronik miyeloid lösemi, Plevral efüzyon ULUSLARARASı HEMATOLOJI-ONKOLOJI DERGISI ARTICLE

Monitoring the Response to Tyrosine Kinase Inhibitor (Tki) Treatment in Chronic Myeloid Leukemia (Cml)

“…Drug tolerability, patient compliance of TKI, physician adherence to TKI, and off-target TKI complications should always be monitored during the CML treatment. Otherwise, late, off-target complications of TKI (lung toxicity, 35 cardiac toxicity, 36 , 37 metabolic syndrome 21 , bone toxicity, 38 arterial and venous occlusive events, 39 pancreas toxicity 1 , and others) may limit the benefits of the given TKI. Proper therapeutic interventions based on the therapeutic monitoring of the CML patients and TKI drugs are described in the ELN 2013 recommendations.…”