Dasatinib-related alveolar pneumonia responsive to corticosteroids

Radaelli, Franca; Bramanti, Stéfania; Fantini, N N; Gavarini, Fabio; Greco, Ivana; Lambertenghi-Deliliers, Giorgio

doi:10.1080/10428190600555868

Cited by 22 publications

(19 citation statements)

References 9 publications

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“…The presence of lymphocytic alveolitis on BAL fluid analysis (four patients), plus resolution by corticosteroids (one patient), the presence of autoantibodies (antinuclear/DNA; one patient), and extrathoracic manifestations (four patients) are consistent with an immune-mediated etiology. Interestingly, the only reported case of dasatinibrelated pneumonia resolved with corticosteroids (16). Patient 2 presented with autoantibodies and symptoms that might be associated with autoimmune disease, which disap-peared after dasatinib interruption.…”

Section: Discussionmentioning

confidence: 99%

Lung Abnormalities after Dasatinib Treatment for Chronic Myeloid Leukemia

Bergeron¹,

Réa²,

Lévy³

et al. 2007

Am J Respir Crit Care Med

180

149

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Tyrosine kinase inhibitors have revolutionized the treatment of chronic myeloid leukemia and are increasingly used for other indications. Fluid retention, however, including pleural effusions, are a significant side effect of imatinib, the first-line treatment for chronic myeloid leukemia. We investigated pleural and pulmonary complications in patients treated with dasatinib, a novel multitargeted tyrosine kinase inhibitor, as part of clinical trial protocols. Of 40 patients who received dasatinib (70 mg twice daily) for imatinib resistance or intolerance, 9 (22.5%) developed dyspnea, cough, and chest pain. Of these nine patients, six had pleural effusions (all were exudates) and seven had lung parenchyma changes with either ground-glass or alveolar opacities and septal thickening (four patients had both pleural effusions and lung parenchyma changes). Lymphocytic accumulations were detected in pleural and bronchoalveolar lavage fluids in all patients except for one who presented with neutrophilic alveolitis. Pleural biopsies revealed lymphocytic infiltration in one patient and myeloid infiltration in another. After dasatinib interruption, lung manifestations resolved in all cases and did not recur in three of four patients when dasatinib was reintroduced at a lower dose (40 mg twice daily). Thus, lung physicians should be aware that lung manifestations, presumably related to an immune-mediated mechanism rather than fluid retention, may occur with dasatinib treatment.

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Section: Discussionmentioning

confidence: 99%

Lung Abnormalities after Dasatinib Treatment for Chronic Myeloid Leukemia

Bergeron¹,

Réa²,

Lévy³

et al. 2007

Am J Respir Crit Care Med

180

149

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“…The histological documentation of a cutaneous small-vessel vasculitis was not executed, and the patient responded dramatically to intravenous methylprednisolone therapy. 88 In another report, Assouline et al reported two cases of painful panniculitis caused by the employ of dasatinib. 89 In the first case, a 55-year-old woman presented in the chronic phase of imatinib-resistant CML and was treated with dasatinib at a dose of 70 mg orally twice daily.…”

Section: Dasatinibmentioning

confidence: 98%

“…described a case of dasatinib‐related alveolar pneumonia associated with the appearance of roundish papules of probably vasculitic nature on the legs of the patients. The histological documentation of a cutaneous small‐vessel vasculitis was not executed, and the patient responded dramatically to intravenous methylprednisolone therapy …”

Section: Dasatinibmentioning

confidence: 99%

Imatinib, dasatinib and nilotinib: a review of adverse cutaneous reactions with emphasis on our clinical experience

Brazzelli

Grasso

Borroni

2013

Acad Dermatol Venereol

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In the last years, several tyrosine kinase inhibitors (TKIs) have been developed and approved for human cancer treatment. Imatinib mesylate was the first of this novel family of drugs that target cancer-specific molecules and signalling pathways. The appearance of imatinib resistances led to the introduction of second-generation TKIs with higher potency and selectivity, such as dasatinib and nilotinib. However, the range of activity of these agents is not simply directed at tumour cells. Patients and their clinicians are indeed frequently confronted with the cutaneous side-effects associated with the employ of these drugs, which represent the most common non-hematological adverse reactions. For this reason, a systematic dermatological survey of patients receiving these therapies is highly important, and an early and appropriate dermatological treatment is required. In this review, we analyse the clinical and pathological characteristics of the most commonly reported adverse skin events associated with first- and second-generation tyrosine kinase inhibitors, with a particular emphasis on our clinical experience.

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“…A case of possible small-vessel vasculitis in the setting of dasatinib-induced alveolitis has also been described. However, a biopsy was not performed, and the eruption as well as the alveolitis responded to intravenous methylprednisone therapy (71).…”

Section: Dasatinibmentioning

confidence: 99%

Adverse cutaneous reactions secondary to tyrosine kinase inhibitors including imatinib mesylate, nilotinib, and dasatinib

Amitay‐Laish¹,

Stemmer

Lacouture

2011

Dermatologic Therapy

109

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Imatinib mesylate is the first of a novel group of drugs that specifically target protein tyrosine kinases, which are central to the pathogenesis of human cancer. It has been approved for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumor and has been found efficacious in other neoplastic diseases. Nilotinib and dasatinib, a second-generation of tyrosine kinase inhibitors (TKIs), were developed in response to findings of emerging imatinib resistance or intolerance to the drug. Cutaneous reactions are the most common nonhematologic side effect of these drugs, and their management is challenging especially in the absence of alternative anticancer agents. The present review focuses on the clinical characteristics and the hypothesized molecular pathogenesis of these first- and second-generation TKIs' cutaneous side effects, and approaches to their treatment. The wide range of adverse effects clarifies the difficulty in designing a truly antitumoral TKI.

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Dasatinib-related alveolar pneumonia responsive to corticosteroids

Cited by 22 publications

References 9 publications

Lung Abnormalities after Dasatinib Treatment for Chronic Myeloid Leukemia

Lung Abnormalities after Dasatinib Treatment for Chronic Myeloid Leukemia

Imatinib, dasatinib and nilotinib: a review of adverse cutaneous reactions with emphasis on our clinical experience

Adverse cutaneous reactions secondary to tyrosine kinase inhibitors including imatinib mesylate, nilotinib, and dasatinib

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