The Impact of Hemodialysis and Liver Cirrhosis on the Plasma Concentrations of Tyrosine Kinase Inhibitors in a Patient with Chronic Myeloid Leukemia

We recently treated a chronic myeloid leukemia (CML) patient with liver and renal dysfunction, who was undergoing hemodialysis (HD). He was treated with 50 mg dasatinib (DAS) once daily just before HD. The maximum plasma concentration of DAS was 227 ng/mL on a non-HD day and 46.9 ng/mL on a HD day....

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Bibliographic Details
Published in:Internal Medicine 2020/11/01, Vol.59(21), pp.2745-2749
Main Authors: Taniguchi, Yasuhiro, Takahashi, Naoto, Miura, Masatomo, Hirase, Chikara, Sueda, Sanae, Espinoza, Jorge Luis, Rai, Shinya, Nakayama, Shoko, Serizawa, Kentaro, Kumode, Takahiro, Watatani, Yosaku, Morita, Yasuyoshi, Tanaka, Hirokazu, Matsumura, Itaru
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Aniline Compounds - blood
Aniline Compounds - therapeutic use
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
bosutinib
Case Report
Chronic myeloid leukemia
Cirrhosis
dasatinib
Dasatinib - blood
Dasatinib - therapeutic use
Female
Hemodialysis
Humans
Internal medicine
Japan
Leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - complications
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - physiopathology
Liver cirrhosis
Liver Cirrhosis - physiopathology
Liver Cirrhosis - therapy
Liver diseases
Male
Middle Aged
Myeloid leukemia
Nitriles - blood
Nitriles - therapeutic use
Plasma
plasma concentrations
Protein Kinase Inhibitors - blood
Quinolines - blood
Quinolines - therapeutic use
Renal Dialysis
Renal function
Renal Insufficiency - physiopathology
Renal Insufficiency - therapy
Treatment Outcome
Tyrosine kinase inhibitors
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Description
Summary:We recently treated a chronic myeloid leukemia (CML) patient with liver and renal dysfunction, who was undergoing hemodialysis (HD). He was treated with 50 mg dasatinib (DAS) once daily just before HD. The maximum plasma concentration of DAS was 227 ng/mL on a non-HD day and 46.9 ng/mL on a HD day. He was subsequently treated with 200 mg bosutinib (BOS) once daily. The plasma concentration of BOS changed from 74.5 ng/mL before HD to 58.8 ng/mL after HD. Our results indicate that close monitoring of the plasma tyrosine kinase inhibitor concentrations should be considered in CML patients with organ impairment.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.4871-20