Dasatinib-induced Colitis

Abstract

Introduction: Dasatinib is a widely used therapy for chronic myeloid leukemia. Although gastrointestinal bleeding has been widely reported with dasatinib therapy for CML, colitis appears to be a much rarer event. Here we report a rare case of colitis associated with dasatinib therapy. Case report: The patient is a 60-year-old Hispanic female with Chronic Myelogenous Leukemia (CML), Philadelphia chromosome positive, since 2007, who was initially treated with Gleevec. The patient developed multiple side effects of Gleevec in 2010 and treatment was switched to dasatinib 100 mg once daily. The patient had age appropriate screening colonoscopy in 2010, before the start of dasatinib, which was unremarkable. In 2012, patient start having abdominal pain with bloody diarrhea. She had a repeat colonoscopy for bloody diarrhea in 2014 and showed diffused colitis. The patient was started on mesalamine, and the intensity of the colitis symptoms decreased. The patient continued to be in remission of her CML on dasatinib. Her colitis symptoms continued to manifest intermittently. The patient subsequently developed hematochezia and iron deficiency anemia. Colonoscopy was done for the 3rd time in 2016, and the patient continued to exhibit diffuse colitis which was confirmed by biopsy. Discussion: Dasatinib therapy is well tolerated, but side effects such as myelosuppression, peripheral edema, skin rashes, and gastrointestinal symptoms have been reported. Commonly reported gastrointestinal side effects include diarrhea, nausea, vomiting, anorexia, and gastrointestinal bleeding. Colitis as a side effect of dasatinib is rarely reported. We are reporting a rare side effect of dasatinib causing colitis.