Practical management of dasatinib for maximum patient benefit

Dasatinib, an oral inhibitor of multiple tyrosine kinases, including BCR-ABL, Src, and platelet-derived growth factor receptor, was approved for patients with imatinib-resistant or -intolerant chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Dasatinib demonstrated efficacy with a well-tolerated safety profile in all phases of CML and Ph+ ALL, which led to its 2006 approval by the U.S. Food and Drug Administration for clinical use. However, although most adverse events are grade 1 or 2, a number of adverse events require management and monitoring to ensure that patients can continue receiving the treatment. This review discusses the appropriate nursing management of key adverse events (cytopenias, fluid retention, bleeding, gastrointestinal toxicity, and cardiotoxicity) to ensure that patients gain maximum benefit from this multitargeted agent.