Association of pleural effusion with an early molecular response in patients with newly diagnosed chronic-phase chronic myeloid leukemia receiving dasatinib: Results of a D-First study

Maki Hagihara, Noriyoshi Iriyama, Chikashi Yoshida, Hisashi Wakita, Shigeru Chiba, Shinichiro Okamoto, Kimihiro Kawakami, Naoki Takezako, Takashi Kumagai, Koiti Inokuchi, Kazuma Ohyashiki, Jun Taguchi, Shingo Yano, Tadahiko Igarashi, Yasuji Kouzai, Satoshi Morita, Junichi Sakamoto, Hisashi Sakamaki

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Despite the efficacy and safety of dasatinib treatment for chronic-phase chronic myeloid leukemia (CML-CP), adverse effects such as pleural effusion (PE) are still a serious concern. We determined the clinical significance of PE incidence using patient data derived from the D-First clinical study. In the present study, chest radiography and quantification of specific lymphocyte subsets were performed routinely after initiation of dasatinib treatment. Among 52 patients with newly diagnosed CML-CP, 17 (33%) developed PE within 18 months after initial dasatinib administration, but all cases were moderate (Grade 1, 10 patients; Grade 2, 7 patients). CD56+ lymphocyte counts at 1 month correlated significantly with the incidence of PE, whereas lymphocytosis did not. The major molecular response (MMR) rate at 3 months (although not at later times) was significantly higher in PE-positive patients than PE-negative patients (59% versus 24%, respectively; P=0.013). Deep molecular response rates did not differ significantly between the PE groups at any time point during the observation period. Our results suggest that an immunemediated mechanism involving natural killer cells underlies the development of PE in patients receiving dasatinib for 18 months. This mechanism likely promotes transient tumor regression in patients newly diagnosed with CML-CP.

Original languageEnglish
Pages (from-to)2976-2982
Number of pages7
JournalOncology reports
Volume36
Issue number5
DOIs
Publication statusPublished - 2016 Nov

    Fingerprint

Keywords

  • Chronic myeloid leukemia
  • Dasatinib
  • Molecular response
  • Newly-diagnosed
  • Pleural effusion

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Hagihara, M., Iriyama, N., Yoshida, C., Wakita, H., Chiba, S., Okamoto, S., Kawakami, K., Takezako, N., Kumagai, T., Inokuchi, K., Ohyashiki, K., Taguchi, J., Yano, S., Igarashi, T., Kouzai, Y., Morita, S., Sakamoto, J., & Sakamaki, H. (2016). Association of pleural effusion with an early molecular response in patients with newly diagnosed chronic-phase chronic myeloid leukemia receiving dasatinib: Results of a D-First study. Oncology reports, 36(5), 2976-2982. https://doi.org/10.3892/or.2016.5110