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Published on: November 18, 2018
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An association between Dasatinib, elevated left atrial pressure and pleural effusion
Sean Tan1, Diva Baggio2, Kylie Porch2
1Victorian Heart Hospital, Monash Health, Melbourne, Victoria, Australia; Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia.
International Journal of Cardiology
|May 31, 2024
Summary
Dasatinib use in chronic myeloid leukemia (CML) is linked to pleural effusions (PE) and elevated left atrial pressure (LAP). Echocardiograms can help identify patients at risk for PE, guiding further investigation and management.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Tyrosine kinase inhibitors (TKIs) like Dasatinib are crucial for chronic myeloid leukemia (CML) treatment.
- Dasatinib therapy is associated with pleural effusions (PE), a known complication.
- The link between hemodynamic parameters, specifically elevated left atrial pressure (LAP) on transthoracic echocardiogram (TTE), and PE development in CML patients is not well understood.
Purpose of the Study:
- To investigate the association between Dasatinib use, elevated LAP, and PE in CML patients.
- To describe the prevalence of elevated LAP on TTE in CML patients undergoing TKI therapy.
- To identify predictors of elevated LAP in this patient cohort.
Main Methods:
- Retrospective analysis of 71 CML patients who underwent TTE during TKI treatment.
- Descriptive statistics to assess relationships between TKI use, PE, and elevated LAP.
- Multivariate logistic regression to determine factors predicting elevated LAP.
Main Results:
- Dasatinib users showed significantly higher rates of elevated LAP (44%) and PE (39%) compared to Nilotinib and Imatinib users.
- Of 15 patients with PE, 14 (93%) were on Dasatinib.
- Elevated LAP was more common in patients with PE (67%) versus those without (16%).
- Multivariate analysis identified Dasatinib use (OR 33.50) and age (OR 1.12) as significant predictors of elevated LAP.
Conclusions:
- An association exists between Dasatinib, elevated LAP on TTE, and PE in CML patients.
- Elevated LAP may serve as a potential marker for predicting and monitoring PE development.
- Further research is warranted to validate the utility of TTE-derived LAP measurements for PE surveillance in CML patients.
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