• Cheng Zhang, Xiao-Qing Luo, and Xi Zhang.
• Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China.
• Medicine (Baltimore). 2018 Sep 1; 97 (38): e12308.

RationaleThere is currently no clinical standard for induction therapy in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph ALL). Chemotherapy in combination with tyrosine kinase inhibitors (TKIs) recognized as the first line of therapy to induce remission in Ph ALL patients; however, both the infectious and non-infectious toxicities remain high and lead to early excessive treatment-related mortality (TRM). Single-agent TKI "monotherapy" may reduce toxicity and TRM; however, TKI induction monotherapy and its effectiveness in the induction of remission in newly diagnosed Ph ALL has yet to be investigated.Patient ConcernsA 59-year-old man who was newly diagnosed Ph ALL with 93% blast cells and a t (9, 22) karyotype. But the patient also suffered from pulmonary infection, including fever and dyspnea.DiagnosesThe patient was newly diagnosed with Ph ALL with pulmonary infection.InterventionsThe patient received oral dasatinib monotherapy (100 mg qd) for 28 days as induction therapy.OutcomesThe patient reached complete remission with negative minimal residual disease detected by real-time quantitative polymerase chain reaction after induction therapy for 28 days.LessonsThis is the first report on the use of dasatinib monotherapy in the absence of other drugs, such as steroids, for induction therapy in a newly diagnosed Ph ALL patient with pulmonary infection.

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