Article ; Online: Successful use of trametinib and dasatinib combined with chemotherapy in the treatment of Ph-positive B-cell acute lymphoblastic leukemia: A case report.
2021 Volume 100, Issue 25, Page(s) e26440
Abstract: Rationale: Relapsed or refractory acute lymphoblastic leukemia poses a significant clinical challenge due to its poor prognosis, showing survival rates of less than a year even with the use of novel therapies. In this report, we describe the safe and ... ...
| Abstract | Rationale: Relapsed or refractory acute lymphoblastic leukemia poses a significant clinical challenge due to its poor prognosis, showing survival rates of less than a year even with the use of novel therapies. In this report, we describe the safe and effective use of trametinib combined with dasatinib in a patient with acute lymphoblastic leukemia (ALL). To the best of our knowledge, this is the first report on the successful use of 2 targeted drugs such as trametinib and dasatinib in a pediatric patient with Ph+ ALL and recurrent pancreatitis. Patient concerns: A 6-year-old boy with ALL and Philadelphia chromosome (Ph+) who had recurrent asparaginase-associated pancreatitis. Diagnosis: The patient was diagnosed with ALL, based on clinical features, laboratory analyses, bone marrow aspiration evaluation in morphology, immunology, cytogenetics, and molecular. Interventions: The patient was treated with dasatinib combined with an intermediate risk-oriented chemotherapy. However, owing to recurrent asparaginase-associated pancreatitis, the patient has to abandon asparaginase in consolidation. Considering the high risk of relapse, we used trametinib and dasatinib combined with chemotherapy as maintenance chemotherapy. Outcomes: After 6 months, there were no obvious side effects or residual disease. Lessons: We suggest that the combination of trametinib and dasatinib may represent a viable option to treat patients with potential relapsed/refractory Ph+ ALL. |
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| MeSH term(s) | Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Asparaginase/administration & dosage ; Asparaginase/adverse effects ; Azathioprine/administration & dosage ; Azathioprine/adverse effects ; Child ; Consolidation Chemotherapy/methods ; Cyclophosphamide/administration & dosage ; Cyclophosphamide/adverse effects ; Cytarabine/administration & dosage ; Cytarabine/adverse effects ; Dasatinib/administration & dosage ; Dasatinib/adverse effects ; Humans ; Maintenance Chemotherapy/methods ; Male ; Pancreatitis/chemically induced ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics ; Pyridones/administration & dosage ; Pyridones/adverse effects ; Pyrimidinones/administration & dosage ; Pyrimidinones/adverse effects ; Treatment Outcome |
| Chemical Substances | Pyridones ; Pyrimidinones ; Cytarabine (04079A1RDZ) ; trametinib (33E86K87QN) ; Cyclophosphamide (8N3DW7272P) ; Asparaginase (EC 3.5.1.1) ; Azathioprine (MRK240IY2L) ; Dasatinib (RBZ1571X5H) |
| Language | English |
| Publishing date | 2021-06-23 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article |
| ZDB-ID | 80184-7 |
| ISSN | 1536-5964 ; 0025-7974 |
| ISSN (online) | 1536-5964 |
| ISSN | 0025-7974 |
| DOI | 10.1097/MD.0000000000026440 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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