Dasatinib-Related Chylothorax

Huang, Yen Min; Wang, Cheng‐Hsu; Huang, Jen‐Seng; Yeh, Kun Yun; Lai, Chien Hong; Wu, Tsung‐Tsong; Chang, Pei Hung; Chang, Yueh Shih; Lan, Yii Jenq

doi:10.4274/tjh.2012.0196

Cited by 24 publications

(28 citation statements)

References 24 publications

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Section: Discussionmentioning

confidence: 99%

“…Chylothorax has been associated with dasatinib use, without clear explanation 1–3. One suggested mechanism is inhibition of platelet-derived growth factor receptor beta (PDGFR-β) expressed in pericytes 3. PDGFR-β regulates angiogenesis as well as lymphangiogenesis, and inhibition of PDGFR-β results in disruption of tumour vasculature, which can result in significant fluid retention 3 9.…”

Section: Discussionmentioning

confidence: 99%

“…Tyrosine kinase inhibitors, particularly dasatinib, have been associated with exudative pleural effusions. Growing evidence from case reports has associated dasatinib with development of chylous effusions as well 1–3…”

Section: Introductionmentioning

confidence: 99%

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Chylothorax: complication attributed to dasatinib use

et al. 2019

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A 63-year-old woman with a medical history of chronic myelogenous leukaemia treated with dasatinib, chronic obstructive pulmonary disease and heart failure with preserved ejection fraction presented with difficulty in breathing. Chest X-ray showed large right-sided pleural effusion, which was confirmed on a CT angiogram of the chest. Echocardiogram showed an ejection fraction of 61% with moderate to severely dilated right ventricle and right ventricular systolic pressure of 60 mm Hg. Diagnostic and therapeutic thoracentesis was performed, and 2.2 L of pleural fluid was removed. Pleural fluid analysis was consistent with chylothorax. Significant symptomatic improvement was noted after thoracentesis. In the absence of an alternate explanation, chylothorax was attributed to dasatinib, which was switched to nilotinib. This resulted in resolution of her pleural effusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chylothorax: complication attributed to dasatinib use

et al. 2019

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“…Hemorrhagic and chylous effusions attributed to dasatinib have been described but are relatively uncommon. 20 CXR should be performed immediately after thoracentesis and repeated every 2 to 4 weeks until the effusion resolves, or becomes stable, or does not recur for 2 to 3 months, to determine the amount of pleural effusion reduction, as well as establish a baseline for comparison in future follow-up. For patients who interrupt dasatinib, it is appropriate to repeat CXR at least once after 2 to 4 weeks to monitor any evidence of progression.…”

Section: Management Of Medium To Large Pleural Diffusionsmentioning

confidence: 99%

Pleural Effusion in Dasatinib-Treated Patients With Chronic Myeloid Leukemia in Chronic Phase: Identification and Management

Cortés

Jiménez

Mauro

et al. 2017

Clinical Lymphoma Myeloma and Leukemia

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Dasatinib has demonstrated durable clinical responses in patients, both as first-line and subsequent lines of therapy. Dasatinib use can result in pleural effusion in some patients, occurring any time during treatment and commonly characterized as mild to moderate in severity. Early identification of symptoms is essential in the proper management of pleural effusion. Prompt confirmation of diagnosis and management of pleural effusion can minimize morbidity and maximize the ability to preserve long-term clinical benefits with dasatinib. Here, we provide guidance on early identification and management of dasatinib-related pleural effusion.

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“…We present four patients with PE secondary to dasatinib, one a chylothorax, a little-reported finding. [ 4 18 19 ] Although there have been numerous reports of dasatinib-related effusions, very few have provided complete pleural fluid analysis.…”

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confidence: 99%

Dasatinib-induced pleural effusion: Chylothorax, an option to consider

et al. 2016

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Dasatinib is a drug for treatment of oncogene fusion protein BCR-ABL-positive chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia resistant/intolerant to imatinib. Pleural effusion (PE) is a common adverse effect, and in this context, we present four cases seen due to this cause. One of them is a chylothorax. The PE grade is variable, and the physiopathology is not well established, although a block in T-lymphocyte function or inhibition of platelet-derived growth factor receptor-β is suggested being involved. The PE is generally a lymphocyte-predominant exudate, but can also present as chylothorax. Several factors have been associated with its appearance, particularly the administration in two daily doses. Low grade (1–2) PEs usually respond well to interrupt the treatment while those of higher grade may also require therapeutic thoracentesis and corticosteroids. There are currently no firm guidelines that establish when to resort to one form of treatment or another.

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Dasatinib-Related Chylothorax

Cited by 24 publications

References 24 publications

Chylothorax: complication attributed to dasatinib use

Chylothorax: complication attributed to dasatinib use

Pleural Effusion in Dasatinib-Treated Patients With Chronic Myeloid Leukemia in Chronic Phase: Identification and Management

Dasatinib-induced pleural effusion: Chylothorax, an option to consider

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