Clinical Case Discussion Forum
To share and enhance best practice management of CML, experts and interested clinicians can discuss difficult or interesting CML cases here. Physicians submit a brief history of the patient and the case for discussion using this forum.
Dasatinib, L asperginase and pancreatitis
I had two patients who were on dasatinib and L asparginase during induction phase of B ALL treatment develop acute pancreatitis. Is it likely that dasatinib enhances the chance of developing acute pancreatitis if also on L asparginase?
For clarity, both patients developed symptoms such as severe abdominal pain, had abnormal pancreatic enzymes and positive ultrasonography.
Case 1 is 13 yrs female, B-ALL Ph+; case 2 is 46 yrs female, B-ALL Ph+.
The pancreatitis developed during induction in both patients.
Coagulation tests were within normal range in both patients.
I think that both drugs have already been stopped. I would never resume l-asparaginase, I would resume Dasatinib 50 mg daily, as soon as pancreatic enzymes and ultrasonography will be normal.
Good luck and best wishes!