Dasatinib
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Demyelinating peripheral neuropathy: case report A 54-year-old woman developed demyelinating peripheral neuropathy (DPN) during treatment with dasatinib for chronic myelogenous leukaemia (CML). The woman, who was diagnosed with BCR-ABL1 positive CML, subsequently started receiving dasatinib 100mg [route not stated]. A complete cytogenetic response (CCyR) was achieved clinically; however, after 2 months of dasatinib therapy, she reported tingling and numbness in bilateral distal extremities. She had no prior infections. Four months later, she was referred to a neurology department due to gradual worsening of her symptoms. Neurological examinations showed no abnormal findings in the cranial nerves. The muscle strength was found to be slightly weakened in the distal dominant extremities with decreasing deep tendon reflexes. Pathological reflex was not observed. She presented with a tingling sensation, which was accompanied by impairment of vibration and tactile sensation in her distal dominant extremities. She did not exhibit tremors. A clinical neurological evaluation suggested sensory-motor peripheral polyneuropathy. Biochemical examination revealed normal results. She tested negative for antibodies associated with autoimmune disease, including anti-SSA, anti-SSB, anti-P-ANCA, anti-C-ANCA, and various antiganglioside antibodies and cryoglobulin. MRI, including gadolinium contrast enhanced imaging showed no abnormal findings in the lumbosacral plexus, brachial plexus and nerve root, and no demyelination of the brain or spinal cord. A nerve conduction velocity (NCV) demonstrated significantly prolonged distal latency and increased duration, indicating demyelinating peripheral neuropathy. She was thus diagnosed with dasatinib-induced DPN [time to reaction onset not clearly stated]. Therefore, the woman’s treatment with dasatinib was discontinued. Two weeks later, her symptoms improved without the need for any additional treatment. After 1 month, she started receiving nilotinib for the CML. A few months later, her neurological symptoms disappeared. The results of nerve conduction studies improved. Inoue H, et al. Dasatinib-induced reversible demyelinating peripheral neuropathy and successful conversion to nilotinib in chronic myelogenous leukemia. Internal Medicine 803518702 59: 2419-2421, No. 19, Oct 2020. Available from: URL: http://doi.org/10.2169/internalmedicine.4824-20
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Reactions 5 Dec 2020 No. 1833
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