Ascites does not accompany pleural effusion developing under dasatinib therapy in patients with CML-CP.

Abstract

Pleural effusion (PE) is the most frequent pulmonary complication of dasatinib, a tyrosine kinase inhibitor (TKI). Concurrent pericardial effusions have been reported in about one-third of the cases. In this study, we aimed to investigate ascites generation in chronic-phase chronic myeloid leukemia (CML-CP) patients developing PE under dasatinib. We conducted a cross-sectional study to evaluate whether pericardial effusion and ascites accompany PE inCML-CP patients treated with dasatinib. For this purpose, consecutive patients with CML-CP who developed PE underdasatinib therapy have been evaluated with chest X-ray, transthoracic echocardiography, and abdominal ultrasonography. There were seven patients, and the median age was50 years (range, 31-73 years). Most of patients were male(n=5). All patients received imatinib as first-line TKI. Sixpatients received dasatinib following imatinib failure in second line. The median duration from dasatinib initiation to PE generation was 58months (range, 8-135months). Consequently, four patients had grade 1 pericardial effusion, and no patient had ascites. In our small study, dasatinib-related PE was associated with low-grade pericardial effusion but no ascites. There are hypothetical explanations of this phenomenon including the simultaneous activation/inhibition of kinases; however, more research needs to be performed on this topic.