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Occurrence of Carcinoma of the Pancreas Following Nilotinib Therapy for Chronic Myeloid Leukemia: Report of a Case with Review of the Literature.

Sekiguchi Y, Shimada A, Matsuzawa M, Imai H, Wakabayashi M, Sugimoto K, Nakamura N, Sawada T, Arita J, Komatsu N, Noguchi M - Turk J Haematol (2015)

Bottom Line: There have been 29 reported cases of secondary neoplasms associated with nilotinib therapy.The present case, however, is the first to be reported as carcinoma of the pancreas.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Hematology, Urayasu, Japan Phone: 047-353-3111 E-mail: yasu_sek@juntendo-urayasu.jp.

ABSTRACT
The patient, a 79-year-old Japanese man, was diagnosed with the chronic phase of chronic myeloid leukemia and begun on nilotinib therapy in April 2011. The therapeutic response was major molecular response in August. About 19 months after the start of nilotinib therapy at 400 mg/day (November 2012), an adenocarcinoma (24 x 20 mm) confined to the head of the pancreas developed. In February 2013, a pancreaticoduodenectomy was performed. The therapy regimen was switched to dasatinib at 100 mg/day, beginning in April. The response was still major molecular response with no recurrence of pancreatic carcinoma in July 2013. There have been 29 reported cases of secondary neoplasms associated with nilotinib therapy. These secondary neoplasms were characterized by relatively frequent occurrence of papilloma (6 cases), gastric cancer (3 cases), fibroma (3 cases), and thyroid neoplasms (2 cases). The present case, however, is the first to be reported as carcinoma of the pancreas. This report describes the case.

No MeSH data available.


Related in: MedlinePlus

Clinical course: A diagnosis of chronic phase of chronic myeloid leukemia was made and the patient was begun on nilotinib at 400 mg/day. He obtained major molecular response. He began suffering from postprandial epigastric pain and a computed tomography scan revealed a tumor mass in the head of the pancreas. The mass was diagnosed as an adenocarcinoma. Nilotinib was discontinued and a pancreaticoduodenectomy was performed. Nilotinib at 400 mg/day was reinstituted, but this was switched to dasatinib at 100 mg/day when despondency appeared. The listless feeling then disappeared and the response is still major molecular response with no indication of pancreatic cancer recurrence.
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f1: Clinical course: A diagnosis of chronic phase of chronic myeloid leukemia was made and the patient was begun on nilotinib at 400 mg/day. He obtained major molecular response. He began suffering from postprandial epigastric pain and a computed tomography scan revealed a tumor mass in the head of the pancreas. The mass was diagnosed as an adenocarcinoma. Nilotinib was discontinued and a pancreaticoduodenectomy was performed. Nilotinib at 400 mg/day was reinstituted, but this was switched to dasatinib at 100 mg/day when despondency appeared. The listless feeling then disappeared and the response is still major molecular response with no indication of pancreatic cancer recurrence.

Mentions: Patient: A Japanese man aged 79, with a chief complaint of increased leukocyte and platelet counts. Past history: He had experienced hepatic angioma and lumbar disk herniation, had an operation for acute appendicitis, was operated on for chronic sinusitis, and had been known to be hypertensive with benign prostatic hypertrophy. Family history, life history, and medication history: Unremarkable. Present illness: The patient had been receiving doxazosin mesylate and tamsulosin hydrochloride since 2003 for hypertension and benign prostatic hypertrophy at a nearby medical clinic. He was referred to us for medical workup in April 2011 because of increased leukocyte count (12,900/µL) and platelet count (69.8x104/µL). Laboratory findings: See Table 1. The amylase (AMY), carbohydrate antigen 19-9 (CA19-9), s-pancreas-1 antigen (SPAN-1), and pancreatic cancer-associated antigen (DUPAN-2) levels were all within their respective reference ranges. Bone marrow examination revealed a nucleated cell count of 36.0x104/µL, a megakaryocyte count of 915/µL, 1.4% blasts, and chromosomal aberrations 46,XY, t(9;22) (q34; q11.2). The patient was thus diagnosed with the chronic phase of CML and was begun on nilotinib at 400 mg/day in April 2011 (Figure 1). The dose was reduced to 400 mg/day because the patient was elderly. In August 2011, i.e. 4 months later, the peripheral blood fused gene level became Amp-CML <5 copies/assay, signaling a major molecular response (MMR) [18].


Occurrence of Carcinoma of the Pancreas Following Nilotinib Therapy for Chronic Myeloid Leukemia: Report of a Case with Review of the Literature.

Sekiguchi Y, Shimada A, Matsuzawa M, Imai H, Wakabayashi M, Sugimoto K, Nakamura N, Sawada T, Arita J, Komatsu N, Noguchi M - Turk J Haematol (2015)

Clinical course: A diagnosis of chronic phase of chronic myeloid leukemia was made and the patient was begun on nilotinib at 400 mg/day. He obtained major molecular response. He began suffering from postprandial epigastric pain and a computed tomography scan revealed a tumor mass in the head of the pancreas. The mass was diagnosed as an adenocarcinoma. Nilotinib was discontinued and a pancreaticoduodenectomy was performed. Nilotinib at 400 mg/day was reinstituted, but this was switched to dasatinib at 100 mg/day when despondency appeared. The listless feeling then disappeared and the response is still major molecular response with no indication of pancreatic cancer recurrence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563202&req=5

f1: Clinical course: A diagnosis of chronic phase of chronic myeloid leukemia was made and the patient was begun on nilotinib at 400 mg/day. He obtained major molecular response. He began suffering from postprandial epigastric pain and a computed tomography scan revealed a tumor mass in the head of the pancreas. The mass was diagnosed as an adenocarcinoma. Nilotinib was discontinued and a pancreaticoduodenectomy was performed. Nilotinib at 400 mg/day was reinstituted, but this was switched to dasatinib at 100 mg/day when despondency appeared. The listless feeling then disappeared and the response is still major molecular response with no indication of pancreatic cancer recurrence.
Mentions: Patient: A Japanese man aged 79, with a chief complaint of increased leukocyte and platelet counts. Past history: He had experienced hepatic angioma and lumbar disk herniation, had an operation for acute appendicitis, was operated on for chronic sinusitis, and had been known to be hypertensive with benign prostatic hypertrophy. Family history, life history, and medication history: Unremarkable. Present illness: The patient had been receiving doxazosin mesylate and tamsulosin hydrochloride since 2003 for hypertension and benign prostatic hypertrophy at a nearby medical clinic. He was referred to us for medical workup in April 2011 because of increased leukocyte count (12,900/µL) and platelet count (69.8x104/µL). Laboratory findings: See Table 1. The amylase (AMY), carbohydrate antigen 19-9 (CA19-9), s-pancreas-1 antigen (SPAN-1), and pancreatic cancer-associated antigen (DUPAN-2) levels were all within their respective reference ranges. Bone marrow examination revealed a nucleated cell count of 36.0x104/µL, a megakaryocyte count of 915/µL, 1.4% blasts, and chromosomal aberrations 46,XY, t(9;22) (q34; q11.2). The patient was thus diagnosed with the chronic phase of CML and was begun on nilotinib at 400 mg/day in April 2011 (Figure 1). The dose was reduced to 400 mg/day because the patient was elderly. In August 2011, i.e. 4 months later, the peripheral blood fused gene level became Amp-CML <5 copies/assay, signaling a major molecular response (MMR) [18].

Bottom Line: There have been 29 reported cases of secondary neoplasms associated with nilotinib therapy.The present case, however, is the first to be reported as carcinoma of the pancreas.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Hematology, Urayasu, Japan Phone: 047-353-3111 E-mail: yasu_sek@juntendo-urayasu.jp.

ABSTRACT
The patient, a 79-year-old Japanese man, was diagnosed with the chronic phase of chronic myeloid leukemia and begun on nilotinib therapy in April 2011. The therapeutic response was major molecular response in August. About 19 months after the start of nilotinib therapy at 400 mg/day (November 2012), an adenocarcinoma (24 x 20 mm) confined to the head of the pancreas developed. In February 2013, a pancreaticoduodenectomy was performed. The therapy regimen was switched to dasatinib at 100 mg/day, beginning in April. The response was still major molecular response with no recurrence of pancreatic carcinoma in July 2013. There have been 29 reported cases of secondary neoplasms associated with nilotinib therapy. These secondary neoplasms were characterized by relatively frequent occurrence of papilloma (6 cases), gastric cancer (3 cases), fibroma (3 cases), and thyroid neoplasms (2 cases). The present case, however, is the first to be reported as carcinoma of the pancreas. This report describes the case.

No MeSH data available.


Related in: MedlinePlus