Dasatinib therapy for leukemia may lead to lung problems

November 14, 2007

NEW YORK (Reuters Health) - Lung abnormalities are seen in a significant minority of patients after dasatinib treatment for chronic myeloid leukemia, according to a case series compiled by French investigators.

In the October 15th issue of the American Journal of Respiratory and Clinical Care Medicine, Dr. Anne Bergeron of Universite Denis Diderot-Paris and colleagues note that fluid retention, including pleural effusions, is a significant side effect of imatinib, the first-line treatment for chronic myeloid leukemia.

To examine whether this might also be the case with another tyrosine kinase inhibitor, dasatinib, the researchers studied data from 40 patients who had received the agent at 70 mg twice daily. All had shown imatinib resistance or intolerance.

Nine of the patients (22.5%) developed dyspnea, cough and chest pain. Seven of these patients had lung parenchyma changes and six had pleural effusions.

Bronchoalveolar lavage fluid analysis performed in five patients showed an increased lymphocyte percentage in four and an increased neutrophil percentage in the fifth patient.

Dasatinib treatment was interrupted in all but one of the patients who was given corticosteroids. The lung manifestations resolved and when dasatinib was reintroduced at 40 mg twice daily in four patients, all but one showed no recurrence.

Summing up, the researchers suggest that if patients show such symptoms, physicians should stop dasatinib "and reintroduce the treatment with caution at a lower dose after lung manifestations have resolved."