Chylothorax Related with Dasatinib in the Treatment of Chronic Myeloid Leukemia: Report of 3 Cases

Abstract

To study the clinical features and prognosis of chylothorax related with dasatinib in treatment of chronic myeloid leukemia(CML). The clinical data from 3 cases of CML with chylothorax after the treatment with dasatinib were collected. The clinical characteristics were analyzed and compared in the light of published literatures. They were treated with imatinib 400 mg once daily after diagnosing the illness as CML. The patients achieved optimal response after switching to dasatinib 100 mg once daily when didn't resisted or endured to imatinib. However, the symptom of dyspnea occurred in the patient after dasatinib treatment for 8,19, and 24 months. The CT examination all showed pleural effusion. According to the results of the pleural effusion test, dasatinib-related chylothorax was diagnosed. Among them 1 case did not stop for dasatinib, only received the support treatment, up to now, the patient still in CMR. The effect of another case was not obvious after giving half dose of dasatinb. The symptoms was disappeared after stopping dasatinb, but there was still a small amount of pleural effusion. Currently, he was been given imatinib 400 mg once a day. The third case stopped taking dasatinib for 48 days, fasting for 35 days, supporting parenteral nutrition and basic therapy. Ligation of thoracic duct was also used to reduce pleural effusion. At present, the patient continued to dasatinib and the symptoms of chest distress disappeared, promising review to the hospital in 3 months. The second-generation TKI dasatinib can lead to serious chylothorax in treatment of CML, timely and appropriate intervention are necessary when finding early detection of lung symptoms.