Clostridioides difficile-induced diarrhoea following dasatinib therapy

Area of Science:

• Oncology
• Gastroenterology
• Infectious Diseases

Background:

• Dasatinib is an oral tyrosine kinase inhibitor used to treat chronic myeloid leukaemia (CML).
• Common dasatinib side effects include myelosuppression, fluid retention, and diarrhea.
• Clostridioides difficile infections (CDIs) are typically associated with antibiotic use, not directly with tyrosine kinase inhibitor therapy.

Observation:

• A 36-year-old man with accelerated phase CML developed severe diarrhea and abdominal pain two months after starting dasatinib.
• Colonoscopy revealed confluent colonic mucosal ulcerations.
• Stool immunoassay confirmed the presence of Clostridioides difficile toxin.

Findings:

• The patient recovered after discontinuing dasatinib and receiving oral metronidazole.
• This case suggests a potential link between dasatinib treatment and the development of CDI.
• The absence of prior antibiotic use in this patient is a key distinguishing factor.

Implications:

• Chemotherapeutic agents like dasatinib should be considered as potential etiological agents in the pathogenesis of CDI.
• This finding broadens the understanding of non-antibiotic-associated CDI.
• Further research is warranted to elucidate the mechanism by which dasatinib may predispose patients to CDI.