Turk J Hematol. 2015; 32(3): 257-262 | DOI: 10.4274/tjh.2013.0322

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

Yasunobu Sekiguchi¹, Asami Shimada¹, Moe Matsuzawa¹, Hidenori Imai¹, Mutsumi Wakabayashi¹, Keiji Sugimoto¹, Noriko Nakamura², Tomohiro Sawada², Junichi Arita³, Norio Komatsu⁴, Masaaki Noguchi^1
1Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Hematology, Urayasu, Japan
²Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Clinical Laboratory, Urayasu, Japan
³The Cancer Institute of the Japanese Foundation for Cancer Research, Gastroenterology Center, Tokyo, Japan
⁴Juntendo University Faculty of Medicine Hospital, Department of Hematology, Tokyo, Japan

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 (24x20 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.

Keywords: Chronic myeloid leukemia, Nilotinib, Secondary malignancy, Carcinoma of the pancreas

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Kronik Miyeloid Lösemi için Kullanılan Nilotinib Tedavisi Sonrasında Gelişen Pankreas Kanseri: Bir Olgu Sunumu ve Literatür Derlemesi

Yasunobu Sekiguchi¹, Asami Shimada¹, Moe Matsuzawa¹, Hidenori Imai¹, Mutsumi Wakabayashi¹, Keiji Sugimoto¹, Noriko Nakamura², Tomohiro Sawada², Junichi Arita³, Norio Komatsu⁴, Masaaki Noguchi^1
1Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Hematology, Urayasu, Japan
²Juntendo University Faculty of Medicine, Urayasu Hospital, Clinic of Clinical Laboratory, Urayasu, Japan
³The Cancer Institute of the Japanese Foundation for Cancer Research, Gastroenterology Center, Tokyo, Japan
⁴Juntendo University Faculty of Medicine Hospital, Department of Hematology, Tokyo, Japan

Yetmiş dokuz yaşında Japon erkek hastaya, Nisan 2011’de kronik evre kronik miyeloid lösemi tanısı konulup, nilotinib tedavisi başlandı. Ağustos’ta majör moleküler yanıt sağlandı. Nilotinib 400 mg/gün dozunda kullanılırken ve tedavi başlangıcından yaklaşık 19 ay geçmişken (Kasım 2012’de), pankreas başına sınırlı (24x20 mm) adenokanser gelişti. Şubat 2013’te pankreatikoduodenektomi yapıldı. Nisan ayından başlayarak tedavi rejimi olarak dasatinib 100 mg/gün’e geçildi. Temmuz 2013’te yanıt halen majör moleküler yanıttı ve pankreas kanserine ait nüks saptanmadı. Literatürde nilotinib tedavisi ile ilişkili olan 29 ikincil neoplazi tespit edildi. Bu ikincil neoplaziler arasında görece daha sık gözlemlenenler papilloma (6 olgu), mide kanseri (3 olgu), fibroma (3 olgu) ve tiroid neoplazileridir (2 olgu). Olgumuz, literatürde nilotinib altında iken gelişen ilk pankreas kanseri olgusudur. Bu yazıda olgu tartışması ve nilotinibe bağlı gelişen ikincil kanserlere ait literatür taraması sunulmaktadır.

Anahtar Kelimeler: Kronik miyeloid lösemi, Nilotinib, İkincil malinite, Pankreas kanseri

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