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

Abstract

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.

Treatment‐free remission with first‐ and second‐generation tyrosine kinase inhibitors

“…Adverse events with TKIs have been well documented, and the possibility of mitigating them may persuade some patients to pursue TFR. Notable adverse events associated with dasatinib are increased pulmonary arterial hypertension (PAH) and pleural effusion . Additionally, increased peripheral arterial occlusive disease has been observed with several TKIs .…”

“…Despite these favorable data, long‐term use of second‐generation TKIs has been associated with adverse events such as pleural effusion and cardiovascular events, which may increase disease morbidity or mortality. Moreover, with long‐term use, even less severe adverse events such as fatigue or musculoskeletal pain may affect patients' quality of life (QoL) .…”

Long‐term data from a phase 3 study of radotinib versus imatinib in patients with newly diagnosed, chronic myeloid leukaemia in the chronic phase (RERISE)

“…Additionally, there were no reported cases of pleural effusion in this study, an adverse event of interest related to TKI (i.e. dasatinib) treatment (Cortes et al , ).…”

Group of Authors Under the Supervision of Academician Vg Savchenko

“…Вероятность развития составляет 14-25 %, по данным различных исследова-телей [81]. Пациенты должны быть предупреждены о том, что в случае появления симптомов плеврального выпота (одышка, кашель, тахикардия) требуется срочный осмотр врача и дополнительное обследо-вание, включающее перкуторное определение границ легких, аускультацию легких, рентгенологическое ис-следование органов грудной клетки, УЗИ плевральных полостей с целью оценить объем плеврального выпота.…”