达沙替尼治疗慢性髓性白血病致单侧血性胸腔积液、心包积液1例并影响因素分析

A Case of Unilateral Bloody Pleural Effusion Complicated with Pericardial Effusion Caused by Dasatinib Treating Chronic Myeloid Leukemia and its Influencing Factors

目的探讨达沙替尼治疗慢性髓性白血病(CML)致胸腔积液、心包积液的临床特点及影响因素。方法通过回顾性分析患者的临床资料并复习相关文献。结果患者胸腔积液经置管引流后好转,将达沙替尼减量为70 mg qd,复发血性胸腔积液,考虑达沙替尼无法耐受,经治疗及方案调整为氟马替尼后积液消失,分析该患者高龄、既往有心血管病史、高血脂症、既往50 mg bid的用药方案,可能为反复胸腔积液的高危因素。结论单侧血性胸腔积液在达沙替尼的治疗过程中较为少见,用药期间应密切关注存在高危因素的患者,并及时干预以获得最佳疗效。

OBJECTIVE This study aimed to investigate the clinical characteristics and influencing factors of pleural and pericardial effusions caused by dasatinib therapy for chronic myeloid leukaemia.METHODS Clinical data of patients were analyzed retrospectively,and relevant literature was reviewed.RESULTS Pleural effusion improved after drainage through canalisation.The dosage of dasatinib was reduced to 70 mg qd.However,bloody pleural effusion recurred,which was caused by intolerance to dasatinib.Pleural effusion disappeared after the treatment,and the therapeutic scheme was switched to flumatinib.Furthermore,advanced age,previous history of cardiovascular diseases,hyperlipidaemia and previous drug regimen at 50 mg bid were analyzed,which might be the high-risk factors for recurrent pleural effusions.CONCLUSION Unilateral bloody pleural effusion rarely occurs during dasatinib therapy.The study findings suggest that during the treatment,there is a need to pay close attention to patients with high-risk factors and adopt timely intervention to achieve an optimal curative effect.