Until now, no studies have addressed the use of dasatinib in hemodialysis patients. Herein, we report the case of a 73-year-old hemodialysis patient with chronic myeloid leukemia (CML) who was treated with dasatinib. For 5 years prior, the patient had received nilotinib for the treatment of CML. Regular hemodialysis was initiated due to progression of hypertensive nephrosclerosis, whereupon nilotinib was discontinued and the patient began receiving 100 mg dose of dasatinib once daily. On dialysis days, dasatinib was administered immediately after completion of dialysis. Four months after starting dasatinib, we performed a pharmacokinetic study. The plasma concentrations of dasatinib before, immediately, and 2 h after the completion of hemodialysis were 7.4, 6.1, and 59.5 ng/mL, respectively. Ultrasound cardiography revealed a gradual decline in ejection fraction during dasatinib therapy. Because the patient’s dasatinib trough concentration was higher (6.1 ng/mL) than the target level (1.5 ng/mL), we suspected the development of dasatinib-related heart dysfunction; thus, dasatinib was discontinued 6 months after its initiation. We concluded that hemodialysis patients are potentially vulnerable to the cardiotoxic effects of dasatinib; monitoring of cardiac function and plasma drug concentration may thus be useful in assessing their condition.

迄今为止，尚无研究涉及达沙替尼在血液透析患者中​​的使用。在此，我们报告了一位接受达沙替尼治疗的73岁的慢性粒细胞白血病（CML）血液透析患者的病例。在此之前的5年中，该患者已接受尼洛替尼治疗CML。由于高血压性肾硬化的进展而开始定期进行血液透析，因此尼洛替尼停用，患者开始每天一次接受100毫克剂量的达沙替尼。在透析日，透析结束后立即给予达沙替尼。开始达沙替尼治疗四个月后，我们进行了药代动力学研究。达沙替尼在血液透析完成之​​前，立即和之后2小时的血浆浓度分别为7.4、6.1和59.5 ng / mL。超声心动图显示达沙替尼治疗期间射血分数逐渐下降。由于患者的达沙替尼谷浓度（6.1 ng / mL）高于目标水平（1.5 ng / mL），因此我们怀疑与达沙替尼有关的心脏功能障碍的发展。因此，达沙替尼开始治疗6个月后就停药了。我们得出的结论是，血液透析患者可能容易受到达沙替尼的心脏毒性作用的影响。因此，监测心脏功能和血浆药物浓度可能有助于评估其状况。我们得出的结论是，血液透析患者可能容易受到达沙替尼的心脏毒性作用的影响。因此，监测心脏功能和血浆药物浓度可能有助于评估其状况。我们得出的结论是，血液透析患者可能容易受到达沙替尼的心脏毒性作用的影响。因此，监测心脏功能和血浆药物浓度可能有助于评估其状况。