The Journal of the Arkansas Medical Society Med Journal Feb 2020_Final | Page 14

13.
Jones MR, Hall
OM, Kaye AM, Kaye
AD.
Drug-induced
acute pancreatitis: A
review. The Oschner
Journal 15: 45-51,
2015.
14.
Kadowaki
N,
Kawaguchi T, Kuroda
J, et al. Discontinuation
of Nilotinib in Patients
with Chronic Myeloid
Leukemia who Have
Maintained Deep Mo-
lecular Response for
at Least Two Years: A
Multicenter Phase 2
Figure 2: patient’s timeline for QRT-PCR showing treatment response and monitoring after discontinuing nilotinib.
Stop Nilotinib (Nilst)
Trial. Blood 128: 790,
Drugs other than nilotinib implicated in acute 4. Hocchaus M, Larson RA, Guilhot F et al.
2016.
pancreatitis on her medication list included Lis-
Long-term outcomes of imatinib treatment
15.
Hocchaus
A,
Masszi
T, Giles FJ et al. Treat-
inopril, pravastatin, metformin and furosemide. 13
for chronic myeloid leukemia. N Engl J Med
ment-free remission following frontline nilo-
Nilotinib was discontinued on day two of hospi-
376:917-927, 2017.
tinib in patients with chronic myeloid leuke-
talization, and patient showed prompt reduction 5. Saglio G, Kim D-W, Issagrisil S et al. Nilo-
mia in chronic phase: results from ENEST
in enzyme elevation and clinical symptoms. She
tinib versus imatinib for newly diagnosed
freedom study. Leukemia 31: 1525-1531,
has since had no recurrence of pancreatitis,
chronic myeloid leukemia. N Engl J Med
2017.
despite continuation of all other medications.
362: 2251-59, 2010.
6. Cortes JE, Jones D, O’Brien S et al. Nilotinib
Nilotinib was discontinued, and the patient was
as front- line treatment for patients with
not started on alternate tyrosine kinase inhibitor;
chronic myeloid leukemia in early chronic
the recurrence of pancreatitis on alternate agent
phase. J Clin Oncol 28: 392-97, 2009.
has not been well-studied. Discontinuation of ni- 7. Hochaus A, Saglio G, Hughes TP et al. Long-
lotinib has been well-studied in Phase 2 trial in
term benefits and risks of frontline nilotinib
patients with sustained deep molecular response
vs imatinib for chronic myeloid leukemia
(MR4.5). Molecular response was sustained for
in chronic phase: 5-year update of the ran-
more than 12 months in more than 50% of the
domized ENESTnd trial. Leukemia 30: 1044-
Heather Williams and
Hannah Henson
patients. Majority of patients (>90%) reinitiated
1054, 2016
Call
on nilotinib due to loss of major molecular re- 8. Steegman JL, Baccarani M, Breccia M et al.
Pharmacist/Attorney
sponse (MR3.0) regained major molecular re-
European Leukemia Net recommendations
or the past 5 years, the M1 decreased lung capacity smokers get
14,15
sponse.
On close monitoring, she continues
for the management and avoidance of ad-
Community Service Repre- in which the students took a short jog
to show deep molecular response a year from
verse events of treatment in chronic myeloid
and then tried to breathe only through
sentatives
discontinuation of nilotinib
(Fig. for
2). the AMS-MSS leukemia.
Leukemia 30: 1648-1671,2016.
a straw. They obviously had difficulty,
have organized a Spring Health Fair
9. Patel V, Pattisapu A, Attia K, Weiss J. Nilo-
which elicited numerous exclamations
for the 5th grade classes at an elemen- tinib-induced
References
acute pancreatitis in a patient
from
the
kids. The
bullying
tary
school
near
the
UAMS
campus.
1. Thompson PA, Kantarjian H, Cortes JE. Di-
with chronic myeloid leukemia.
Case station
Rep
www.DarrenOQuinn.com
agnosis
treatment
of teach
chronic the
myeloid
2017
22;11(2):344-347.
consisted of
a May
series
of skits played
The and
purpose
is to
students Gastroenterol.
leukemia
2015.
Mayo
10. Engel
T, Justo D, Amitai M, Volchek Y,
out by the medical students that dem-
at a (CML)
young IN age
how
to Clin
eat Proc
healthy,
90: why exercise is important, about bul-
1440-1454, 2015.
Mayan
H. Nilotinib-associated
acute pancre-
onstrated
what constituted
bullying,
2. O'Brien
SG,
Guilhot
F,
Larson
RA,
et
al.
atitis.
Ann
Pharmacother.
2013
Jan;47(1):e3
lying, the ill effects of tobacco use and inappropriate responses and then the
Imatinib compared with interferon and low- 11. Yamada, Toshiki et al. Symptomatic Acute
how to stay safe during the summer. appropriate response to be given when
dose cytarabine for newly diagnosed chron-
Pancreatitis Induced by Nilotinib: A Re-
This year, M1 Representatives, Han- someone is being bullied. Of course
ic-phase chronic myeloid leukemia. N Engl J
port of Two Cases. Internal medicine (To-
nah Henson, Garret Theil, Amelia the medical students had fun with this
Med 348:994-1004, 2003.
kyo, Japan) vol. 55,23 (2016): 3495-3497.
Little Rock, Arkansas
one and the kids could be heard laugh-
McDurmott, and Emily Neaville did a
3. European
Leukemia Net recommendations
doi:10.2169/internalmedicine.55.7104
ing all around the fair.
fantastic job of recruiting their fellow
for the
management of chronic myeloid leu- 12. Quinlan
JD. Acute Pancreatitis. Am Fam
The exercise station demonstrated
classmates to participate and were also
kemia:
2013. Blood 122:872-884,2013.
Physician
90: 632-639, 2014.
AMS-MSS Spring Health Fair
F
responsible for making arrangements 3-4 ways the kids should be physically
with each of the elementary schools. active and still have fun, including play-
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