Abstract
For hemodialysis patients, an older average age reflects a more frequent occurrence of malignancy. However, reports on chemotherapy for hemodialysis patients are lacking. For chronic myeloid leukemia (CML) in hemodialysis patients, there have been few reports about long-term survival with imatinib, and no reports about therapy with dasatinib. Our case involves an 87-year-old man who was introduced to hemodialysis at 81 years old. He was diagnosed with CML at 82 years old by detection of Philadelphia chromosome in bone marrow, and was treated with imatinib. The basic dose of imatinib was 300 mg on alternate days. Complete hematologic response was achieved for three years. However, refractoriness to imatinib gradually appeared. Due to imatinib refractoriness, imatinib was switched to dasatinib. Although there was complete hematologic response, there was also cardiotoxicity, including cardiac wall motion hypokinesis, and heart failure worsened in spite of a decrease in dry weight. After stopping dasatinib, the cardiotoxicity disappeared immediately. This case shows that imatinib can control CML even in hemodialysis patients, and dasatinib can easily induce cardiotoxicity in hemodialysis patients.
