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Dasatinib-induced pleural effusions: a lymphatic network disorder?
Mark Goldblatt1, J Terrill Huggins, Peter Doelken
1Division of Pulmonary and Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Abstract:
Dasatanib, which has been approved for rescue therapy for patients with imatinib-resistant chronic myelogenous leukemia and Philadelphia chromosome positive acute lymphoblastic leukemia, is a novel, orally available multitargeted kinase inhibitor of BCR-ABL and SRC family kinases (Quintas-Cardama et al, J Clin Oncol 2007;25:3908-14). It binds to both active and inactive conformations of the ABL gene and is 325 times more potent than imatinib in inhibiting the growth of BCR/ABL cells in vitro (Morelock and Sahn, Chest 1999;116:212-21; Huggins and Sahn, Clin Chest Med 2004;25:141-53). Although dasatinib is a generally well-tolerated drug in the treatment of Philadelphia chromosome positive hematopoetic malignancies, pleural effusions have been frequently noted and have been reported in up to 35% of patients (Sahn SA. Drug-induced pleural disease. In: Camus P, Rosenow E, editors. Drug-induced iatrogenic lung disease. London: Hodder Arnold; 2009). Although there have been numerous reports of effusions, none have provided complete pleural fluid analysis; therefore, we report 2 patients with dasatinib-induced pleural effusion with complete pleural fluid analysis.
Insights
Dasatinib is a targeted cancer therapy that can cause pleural effusion, a buildup of fluid around the lungs. This report details two cases with complete pleural fluid analysis to better understand this side effect.
Area of Science:
- Oncology
- Pharmacology
Background:
- Dasatinib is an oral multitargeted kinase inhibitor approved for treating imatinib-resistant leukemias.
- It targets BCR-ABL and SRC family kinases, showing high potency against BCR/ABL cells.
- While generally well-tolerated, dasatinib is associated with a notable incidence of pleural effusions.
Observation:
- Pleural effusions are a frequent adverse event in patients treated with dasatinib.
- Previous reports lacked comprehensive pleural fluid analysis for these effusions.
- This study presents two cases of dasatinib-induced pleural effusion with detailed fluid analysis.
Findings:
- Complete pleural fluid analysis was performed for two patients experiencing dasatinib-induced pleural effusion.
- The analysis provides detailed characterization of the pleural fluid in these cases.
- This data aims to elucidate the nature of dasatinib-induced pleural effusions.
Implications:
- Understanding the characteristics of pleural fluid in dasatinib-induced effusions can aid in diagnosis and management.
- This detailed analysis contributes to the broader knowledge of drug-induced pleural disease.
- Further research may benefit from these findings to optimize patient care and minimize adverse events.
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Clinical Manifestations: