Successful Control of Dasatinib-related Chylothorax by the Japanese Herbal Medicine "Goreisan"

Sasaki, Hisashi; Kimizuka, Yoshifumi; Ogata, Hiroyasu; Okada, Yosuke; Ota, Shinichiro; Sano, Tomoya; Watanabe, Chie; Maki, Yohei; Yamamoto, Takayuki; Tagami, Yoichi; Miyata, Jun; Hayashi, Naoaki; Fujikura, Yuji; Kawana, Akihiko

doi:10.2169/internalmedicine.3002-19

Cited by 9 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We reviewed the English literature in the MEDLINE database to investigate the clinical characteristics of dasatinib-induced chylothorax. After excluding articles where only the abstracts had been written in English or with only meeting abstracts available, it was found that nine cases had been reported to date, including this case ( Table 1 ) [ 4 , 5 , [11] , [12] , [13] , [14] , [15] , [16] ]. Of the nine cases, eight were adults and one was a child.…”

Section: Discussionmentioning

confidence: 99%

Dasatinib-induced massive left chylothorax in a patient with chronic myeloid leukemia

Makimoto

Misawa

Maeda

et al. 2022

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Dasatinib-induced massive left chylothorax in a patient with chronic myeloid leukemia

Makimoto

Misawa

Maeda

et al. 2022

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

“…Another possible mechanism of the development of this complication could be that dasatinib inhibits tyrosine kinase platelet-derived growth factor receptor beta (PDGFR-β), which regulates angiogenesis, lymphangiogenesis, and vascular smooth muscle cell proliferation. This in turn results in microangiopathy and defective vascular remodeling that can then lead to leakage of lymph fluid into the pleural space [6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Chylous Pleural Effusions in a Patient Treated With Dasatinib

Nasir¹,

Liano²,

Manfredi³

2022

Cureus

View full text Add to dashboard Cite

Dasatinib is a second-generation BCR-ABL tyrosine kinase inhibitor (TKI) that is approved for the treatment of chronic myeloid leukemia (CML), a myeloproliferative disorder seen commonly in adults over the age of 50. Dasatinib is superior in tolerance and efficacy to first-generation TKIs such as imatinib, given its ability to target mutation products that are resistant to first-generation TKIs. One of the common side effects of dasatinib includes pleural effusion which can be seen in up to 25% of patients on treatment. These effusions are predominantly exudative; however, they tend to resolve upon discontinuation of the drug. While infrequent, chylous effusions have been reported with the use of dasatinib; they tend to resolve following discontinuation of the drug. We present a case of a patient who was treated with dasatinib and developed a chylous effusion which was refractory to the discontinuation of the medication. Our patient was switched to imatinib and since his first episode, he has had multiple reaccumulation requiring thoracentesis, all of which have revealed chylous pleural fluid as per fluid analysis. We present this case to highlight a rare adverse effect of dasatinib which, via an unknown mechanism, can potentially lead to irreversible damage to the lymphatic duct resulting in recurrent chylous effusions.

show abstract

“…It also appears to be reversible by the antioxidant agent N-acetylcysteine (NAC) in an animal model [9]. In a Japanese case report, pleural effusion was reported to have been successfully reduced through the administration of the herbal medicine Goreisan [8].…”

Section: Discussionmentioning

confidence: 99%

“…Cases of drug‐induced chylothorax are rare, and the pathophysiology of dasatinib‐related chylothorax has not yet been fully characterized. One possible mechanism of this complication could be that dasatinib inhibits PDGFR‐β, which regulates angiogenesis, lymphangiogenesis, and vascular smooth muscle cell proliferation, resulting in the leakage of lymph fluid into the pleural space [8]. Another possible mechanism is the inhibition of Src kinase by dasatinib.…”

Section: Discussionmentioning

confidence: 99%

Dasatinib‐induced chylothorax in a patient with chronic myeloid leukaemia: a case report and literature review

Hsu

2021

Respirology Case Reports

View full text Add to dashboard Cite

Dasatinib is a potent and effective second‐generation oral tyrosine kinase inhibitor that is clinically indicated for the treatment of imatinib‐resistant or imatinib‐intolerant breakpoint cluster region‐Abelson (BCR‐ABL)‐positive chronic myeloid leukaemia (CML) or for Philadelphia chromosome‐positive acute lymphocytic leukaemia. The most common adverse events associated with dasatinib therapy are skin rash, gastrointestinal upset, pancytopenia, pulmonary hypertension, and fluid retention, including pleural effusion. However, chylothorax secondary to dasatinib administration has rarely been reported. Although the underlying mechanism leading to dasatinib‐induced chylothorax is uncertain, the preferred treatment options are usually supported with diuretics or systemic steroids. Moreover, the discontinuation of the drug is mandatory in refractory cases. Here, we present the case of a patient with dasatinib‐induced chylothorax, and review the previously reported cases in the literature.

show abstract

Successful Control of Dasatinib-related Chylothorax by the Japanese Herbal Medicine "Goreisan"

Cited by 9 publications

References 14 publications

Dasatinib-induced massive left chylothorax in a patient with chronic myeloid leukemia

Dasatinib-induced massive left chylothorax in a patient with chronic myeloid leukemia

Recurrent Chylous Pleural Effusions in a Patient Treated With Dasatinib

Dasatinib‐induced chylothorax in a patient with chronic myeloid leukaemia: a case report and literature review

Contact Info

Product

Resources

About