Table 2.
Clinical and pathological findings of previously reported 7 cases of dasatinib-induced nephrotic syndrome and our case
| Case No | 1st Author, (Ref. No.) | Agea | Sex | Disease | Duration of DASa | Main findings in renal biopsy | Urinary proteina | Serum Cra | Pleural effusiona | Treatment | Period between withdrawal of DAS and remission |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Wallace, (Ref [4]) | 63 yo | F | CML | 3 Months | Mild increased mesangial matrix, focal corrugation of the glomerular basement membranes and focal foot process effacement | 3.9 g/day | 0.79 mg/dl | (–) | DAS → IMA | 2 Weeks |
| 2 | Ruebner, (Ref [5]) | 3 yo | F | CML | 1 To 2 yearsb | Focal global sclerosis, a few segmental mesangial proliferation and focal foot process effacement | 17 g/gCr | 0.3 mg/dl | NA | DAS + Steroids → partial remission → discontinued DAS | 2 Weeks |
| 3 | Hirano, (Ref [6]) | 64 yo | F | Ph+ALL | > 0.5 Monthc | No renal biopsy | 3.9 g/day | 0.34 mg/dl | NA | Reduced DAS + Steroids → increased proteinuria → discontinued DAS | 1 Week |
| 4 | Lim, (Ref [7]) | 7 yo | M | Ph+ALL | > 1 Monthd | Diffuse l foot process effacement | 5.6 g/day | NA | NA | Discontinued DAS | 1 Week |
| 5 | Ochiai, (Ref [8]) | 40 yo | M | CML | 3 Months | Swelling of endothelial cells, foot process effacement and focal randomly arranged fibril deposition | 12.2 g/gCr | 0.87 mg/dl | NA | DAS → NIL | 2 Weeks |
| 6 | De Luca, (Ref [9]) | 45 yo | F | CML | 6 Months | No renal biopsy | 4.0 g/day | 0.90 mg/dl | (–) | DAS → IMA | 4 Weeks |
| 7 | Mandac Rogulj (Ref [10]) | 33 yo | F | CML | 2 Years | No renal biopsy | 6.19 g/L | NA | NA | Reduced DAS | NAf |
| 8 | Our Case | 57 yo | F | CML | 58 Monthse | Mild mesangial proliferation, immune complex deposition in mesangial area, and focal foot process effacement | 1.63 g/gCr | 1.05 mg/dl | ( +) | DAS → BOS | 3 Weeks |
Ref reference, yo years old, Cr creatinine, CML chronic myelogenous leukemia, Ph+ ALL Philadelphia chromosome-positive acute lymphocytic leukemia, NA not available, DAS dasatinib, IMA imatinib, NIL nilotinib, BOS bosutinib
aAt the time of renal biopsy or at the time of treatment change, when renal biopsy was not performed
bEstimated period based on the clinical history
cProteinuria was detected 2 weeks administration of 140 mg/day of DAS, which was increased from 100 mg/day
dProteinuria was detected 26 days after hematopoietic stem cell transplantation, which was performed after the achieving remission with DAS
eIncluding intermittent withdrawal periods
fUrinary protein returned to normal level by reduction of dasatinib