Dasatinib-Induced Chylothorax in Chronic Myeloid Leukemia

Baloch, Zulfiqar Qutrio; Abbas, Shabber Agha; Bhatti, Hammad; Braver, Yvonne; Ali, Sayed

doi:10.1080/08998280.2017.11929535

Cited by 17 publications

(21 citation statements)

References 20 publications

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“…It can be classified as traumatic or non-traumatic. The leading causes are thoracic surgery and malignancy, respectively 1. Medications typically do not cause chylous effusions.…”

Section: Discussionmentioning

confidence: 99%

“…Chylothorax has been associated with dasatinib use, without clear explanation 1–3. One suggested mechanism is inhibition of platelet-derived growth factor receptor beta (PDGFR-β) expressed in pericytes 3.…”

Section: Discussionmentioning

confidence: 99%

“…Src is a proto-oncogene encoding a non-receptor tyrosine kinase which is widely expressed in haematopoietic cells in lung tissue 1 10 11. It is responsible for capillary integrity by inducing the expression of vascular endothelial growth factor 1 12 13. Inhibition of Src results in changes in vascular permeability as well as pleural epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…Chylothorax usually results from disruption of the normal chyle flow in the thoracic duct, resulting in leakage of lymphatic fluid into the pleural space 1. Malignancy-induced thoracic duct obstruction, typically from lymphoma, is the leading cause of nontraumatic chylothorax 1. Tyrosine kinase inhibitors, particularly dasatinib, have been associated with exudative pleural effusions.…”

Section: Introductionmentioning

confidence: 99%

“…Tyrosine kinase inhibitors, particularly dasatinib, have been associated with exudative pleural effusions. Growing evidence from case reports has associated dasatinib with development of chylous effusions as well 1–3…”

Section: Introductionmentioning

confidence: 99%

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Chylothorax: complication attributed to dasatinib use

et al. 2019

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A 63-year-old woman with a medical history of chronic myelogenous leukaemia treated with dasatinib, chronic obstructive pulmonary disease and heart failure with preserved ejection fraction presented with difficulty in breathing. Chest X-ray showed large right-sided pleural effusion, which was confirmed on a CT angiogram of the chest. Echocardiogram showed an ejection fraction of 61% with moderate to severely dilated right ventricle and right ventricular systolic pressure of 60 mm Hg. Diagnostic and therapeutic thoracentesis was performed, and 2.2 L of pleural fluid was removed. Pleural fluid analysis was consistent with chylothorax. Significant symptomatic improvement was noted after thoracentesis. In the absence of an alternate explanation, chylothorax was attributed to dasatinib, which was switched to nilotinib. This resulted in resolution of her pleural effusions.

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“…It can be classified as traumatic or non-traumatic. The leading causes are thoracic surgery and malignancy, respectively 1. Medications typically do not cause chylous effusions.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chylothorax: complication attributed to dasatinib use

et al. 2019

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Dasatinib‐induced chylothorax: An unusual presentation of a common adverse event—A case report with literature review

Paul

Ellahie

Almohtasib

et al. 2021

eJHaem

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Tyrosine kinase inhibitors (TKIs) are the key agents for treating CML and BCR–ABL+ B‐ALL. Dasatinib is a potent second‐generation TKI. Here, we have discussed the case of a 51‐year‐old gentleman diagnosed with B‐myeloid mixed‐phenotype acute leukemia with t(9;22)(q34.1;q11.2); BCR–ABL1p210, in complete hematological, cytogenetic, and molecular remission, who developed chylothorax. Though pleural effusion is a commonly observed adverse effect of dasatinib therapy, chylothorax is rare. The ability of Dasatinib to inhibit multiple families of tyrosine kinases could be considered the etiology. Discontinuation of the drug resolved the symptom, but pleural effusion recurred once Dasatinib was resumed. Chylothorax induced by Dasatinib is a differential to be kept in mind, owing to the limited number of cases being reported.

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Dasatinib‐induced chylothorax in a patient with chronic myeloid leukaemia: a case report and literature review

Hsu

2021

Respirology Case Reports

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Dasatinib is a potent and effective second‐generation oral tyrosine kinase inhibitor that is clinically indicated for the treatment of imatinib‐resistant or imatinib‐intolerant breakpoint cluster region‐Abelson (BCR‐ABL)‐positive chronic myeloid leukaemia (CML) or for Philadelphia chromosome‐positive acute lymphocytic leukaemia. The most common adverse events associated with dasatinib therapy are skin rash, gastrointestinal upset, pancytopenia, pulmonary hypertension, and fluid retention, including pleural effusion. However, chylothorax secondary to dasatinib administration has rarely been reported. Although the underlying mechanism leading to dasatinib‐induced chylothorax is uncertain, the preferred treatment options are usually supported with diuretics or systemic steroids. Moreover, the discontinuation of the drug is mandatory in refractory cases. Here, we present the case of a patient with dasatinib‐induced chylothorax, and review the previously reported cases in the literature.

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Dasatinib-Induced Chylothorax in Chronic Myeloid Leukemia

Cited by 17 publications

References 20 publications

Chylothorax: complication attributed to dasatinib use

Chylothorax: complication attributed to dasatinib use

Dasatinib‐induced chylothorax: An unusual presentation of a common adverse event—A case report with literature review

Dasatinib‐induced chylothorax in a patient with chronic myeloid leukaemia: a case report and literature review

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