Dasatinib Induced Pulmonary Hypertension and Third Space Effusion: A Case Series and Literature Review

Dasatinib, a Tyrosine kinase inhibitor, functions by preventing an abnormal protein that instructs cancer cells to proliferate. It is used to treat chronic myeloid leukemia in adults who can no longer benefit from other leukemia medications, including imatinib, or those who cannot tolerate first-line medicines due to their side effects. Pleural effusion and pulmonary hypertension induced by the drug dasatinib are uncommon but serious complications that impact the pulmonary vasculature. Here, we describe a series of patients with chronic myeloid leukemia receiving dasatinib who subsequently experienced pleural effusion and pulmonary hypertension. In 2 of the 3 cases, dasatinib was used as first-line therapy, highlighting the importance of recognizing these adverse effects even when it is used upfront rather than solely after failure of first-generation TKIs. The patient's symptoms significantly improved after stopping dasatinib and starting supportive care. This case series emphasizes the need to raise awareness among clinicians, the importance of early recognition, and the timely initiation of alternative treatment to enhance patient outcomes.