Dasatinib monotherapy for newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia with pulmonary infection in induction remission: A case report and review of the literature

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Abstract

Rationale:

There is currently no clinical standard for induction therapy in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Chemotherapy in combination with tyrosine kinase inhibitors (TKIs) recognized as the first line of therapy to induce remission in Ph+ ALL patients; however, both the infectious and non-infectious toxicities remain high and lead to early excessive treatment-related mortality (TRM). Single-agent TKI “monotherapy” may reduce toxicity and TRM; however, TKI induction monotherapy and its effectiveness in the induction of remission in newly diagnosed Ph+ ALL has yet to be investigated.

Patient concerns:

A 59-year-old man who was newly diagnosed Ph+ ALL with 93% blast cells and a t (9, 22) karyotype. But the patient also suffered from pulmonary infection, including fever and dyspnea.

Diagnoses:

The patient was newly diagnosed with Ph+ ALL with pulmonary infection.

Interventions:

The patient received oral dasatinib monotherapy (100 mg qd) for 28 days as induction therapy.

Outcomes:

The patient reached complete remission with negative minimal residual disease detected by real-time quantitative polymerase chain reaction after induction therapy for 28 days.

Lessons:

This is the first report on the use of dasatinib monotherapy in the absence of other drugs, such as steroids, for induction therapy in a newly diagnosed Ph+ ALL patient with pulmonary infection.

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