Improvement of bone marrow necrosis by tyrosine kinase inhibitor substitution in a pediatric patient with Philadelphia chromosome-positive acute lymphoblastic leukemia
Improvement of bone marrow necrosis by tyrosine kinase inhibitor substitution in a pediatric patient with Philadelphia chromosome-positive acute lymphoblastic leukemia
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酪氨酸激酶抑制剂替代治疗费城染色体阳性急性淋巴细胞白血病儿科患者骨髓坏死的改善
DOI：
10.1097/mph.0000000000002157
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Takita J
中科院分区：
文献类型：
--
作者：
Mikami T;Kato I;Oiki N;Okamoto S;Kamitori;Tasaka K;Ogata H;Tanaka K;Umeda K;Hiramatsu H;Okamoto T;Adachi S;Takita J
骨髓坏死（BMN）描述髓样组织坏死而不累及皮质骨。伊马替尼是一种酪氨酸激酶抑制剂，在恶性疾病治疗期间可触发BMN。在这种情况下，有必要减少伊马替尼剂量或停止给药，这可能影响治疗结果。在这里，我们报告了一名6岁的费城染色体阳性急性淋巴细胞白血病男孩，他对伊马替尼的反应是BMN。我们用达沙替尼代替伊马替尼，坏死灶逐渐消失，没有加重。在费城染色体阳性急性淋巴细胞白血病伴BMN，酪氨酸激酶抑制剂替代可能允许继续化疗而不降低强度。
Bone marrow necrosis (BMN) describes necrosis of the myeloid tissues without cortical bone involvement. Imatinib, a tyrosine kinase inhibitor, can trigger BMN during the treatment of malignant disease. In such cases, it is necessary to reduce imatinib dose or discontinue its administration, which could influence treatment outcomes. Here, we report a 6-year-old boy with Philadelphia chromosome-positive acute lymphoblastic leukemia, who developed BMN in response to imatinib. We replaced imatinib with dasatinib, and necrotic lesions gradually disappeared and were never exacerbated. In Philadelphia chromosome-positive acute lymphoblastic leukemia with BMN, tyrosine kinase inhibitor replacement may allow continued chemotherapy without intensity reduction.