Development of Colonic Polyposis in a Woman With Chronic Myeloid Leukemia Treated With Dasatinib

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• Chronic myeloid leukemia (CML) is a malignancy driven by tyrosine kinase activity.
• Dasatinib, a second-generation tyrosine kinase inhibitor (TKI), is a preferred CML treatment with known gastrointestinal (GI) side effects.
• Colonic polyposis is a rare, under-described complication of dasatinib therapy.

Purpose of the Study:

• To report a rare case of colonic polyposis secondary to dasatinib treatment in a patient with CML.
• To describe the clinical presentation, management, and outcome of this rare adverse event.
• To hypothesize potential mechanisms underlying dasatinib-induced colonic polyposis.

Main Methods:

• A case presentation of a 66-year-old woman with CML on dasatinib therapy.
• Routine colonoscopy revealing asymptomatic colonic polyposis.
• Histopathological examination of polyps and assessment following dasatinib cessation.

Main Results:

• Incidental discovery of asymptomatic colonic polyposis after 11 months of dasatinib therapy.
• Histopathology showed reactive inflammatory changes, with no dysplasia or neoplasia.
• Complete resolution of colonic polyposis after discontinuation of dasatinib.

Conclusions:

• Dasatinib-induced colonic polyposis is a rare but potentially reversible adverse effect.
• Hypothesized mechanisms involve dasatinib's inhibition of kinase pathways, regulatory T cells, and STAT5 signaling, leading to intestinal inflammation.
• Increased awareness and further research into the pathogenesis of this rare complication are warranted.