Side Effects of dasatinib: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Major Research Findings

Dasatinib is an effective second-generation tyrosine kinase inhibitor for the treatment of chronic myeloid leukemia (CML), but it also carries the risk of side effects. Dasatinib was designed to inhibit ABL and SRC, but it also has activity in multiple other kinases, including c-KIT, PDGFR-α, PDGFR-β, and ephrin receptor kinases. 19

Dasatinib is administered as a once-daily dose of 100 mg in chronic phase CML and 140 mg in Ph+ALL or blastic phase, regardless of food intake. 19

Dasatinib can cause side effects such as thrombocytopenia, neutropenia, pleural effusion, and gastrointestinal symptoms. 19 10

Chylothorax has been reported as a side effect of dasatinib. Chylothorax is a condition where lymphatic fluid accumulates in the chest cavity, causing symptoms such as difficulty breathing and chest pain. Dasatinib-induced chylothorax is rare, but it can occur in children. 2 Dasatinib-induced chylothorax is thought to be caused by damage to the lymphatic vessels or increased lymphatic fluid production. 2

Dasatinib can reduce intestinal blood flow and impair the function of the intestinal barrier. 15

Facial edema has been reported as a side effect of dasatinib. 11 Facial edema may improve by discontinuing dasatinib. 11

Dasatinib has also been used to treat complications related to CAR-T cell therapy. 14 CAR-T cell therapy is a treatment that involves modifying immune cells (T cells) to attack cancer cells. Dasatinib may be effective in treating cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) associated with CAR-T cell therapy. 14

Lower doses of dasatinib may be effective in reducing side effects. 5 Lower doses of dasatinib have been found to be better tolerated and effective than the approved 100 mg daily dose. 5

To reduce side effects of dasatinib, it is necessary to use drugs that prevent or treat side effects in combination with dasatinib. 12 YQFM (YiQiFuMai powder injection) has been shown to reduce the side effects of dasatinib. 12

Dasatinib can suppress immune function. 7 Patients taking dasatinib may be more susceptible to infections such as tuberculosis. 7

Dasatinib can promote the growth of capillaries in the skin, potentially leading to the development of hemangiomas. 21 Dasatinib can promote angiogenesis by activating the MEK/ERK pathway. 21

Dasatinib, when used in combination with anticancer drugs, can worsen side effects. 16

Dasatinib can cause side effects in the heart, kidneys, endocrine system, and reproductive organs. 9

Dasatinib can cause acneiform eruptions on the skin. 3 Dasatinib-induced acneiform eruptions can be treated with drugs such as sarecycline. 3

Dasatinib can cause recurrent chylothorax. 20 Dasatinib-induced chylothorax is thought to be caused by damage to the lymphatic vessels. 20

Reasons for Side Effects

Dasatinib inhibits multiple kinases, which can cause a variety of side effects. Dasatinib can also affect various cellular functions such as cell growth, differentiation, and immune function. Therefore, the side effects of dasatinib vary depending on individual patient factors such as their constitution, the type of drug being taken, and the dosage. 19 10

Common Side Effects

Thrombocytopenia, Neutropenia

Dasatinib can suppress bone marrow function, which can lead to thrombocytopenia and neutropenia. 19 10

Pleural Effusion

Dasatinib can cause pleural effusion by increasing fluid retention in the body. 19 10 In addition to pleural effusion, dasatinib can also cause side effects such as ascites and peripheral edema. 4 11 Dasatinib-induced pleural effusion may improve by discontinuing dasatinib. 4

Gastrointestinal Symptoms

Dasatinib can cause gastrointestinal side effects. 19 10 Dasatinib-induced gastrointestinal symptoms include nausea, vomiting, diarrhea, and abdominal pain. 19 10 Dasatinib can reduce intestinal blood flow and impair the function of the intestinal barrier. 15

Chylothorax

Chylothorax has been reported as a side effect of dasatinib. 2 Chylothorax is a condition where lymphatic fluid accumulates in the chest cavity, causing symptoms such as difficulty breathing and chest pain. 2 Dasatinib-induced chylothorax is rare, but it can occur in children. 2 Dasatinib-induced chylothorax is thought to be caused by damage to the lymphatic vessels or increased lymphatic fluid production. 2 Dasatinib-induced chylothorax may improve by discontinuing dasatinib. 2 However, recurrent chylothorax due to dasatinib has also been reported. 20

Facial Edema

Facial edema has been reported as a side effect of dasatinib. 11 Facial edema may improve by discontinuing dasatinib. 11

Skin Symptoms

Dasatinib can cause skin side effects. 10 Dasatinib-induced skin symptoms include rash, itching, and pigmentation. 10 Dasatinib can promote the growth of capillaries in the skin, potentially leading to the development of hemangiomas. 21 Dasatinib-induced acneiform eruptions can be treated with drugs such as sarecycline. 3

Other

Dasatinib can cause side effects in the heart, kidneys, endocrine system, and reproductive organs. 9 Dasatinib can suppress immune function. 7 Dasatinib, when used in combination with anticancer drugs, can worsen side effects. 16 Dasatinib has also been used to treat complications related to CAR-T cell therapy. 14

Side Effect Management

Thrombocytopenia, Neutropenia

Management of thrombocytopenia and neutropenia includes blood product transfusions and administration of hematopoietic growth factors. 19 10

Pleural Effusion

Management of pleural effusion includes chest fluid drainage (thoracentesis) and administration of diuretics. 19 10 Dasatinib-induced pleural effusion may improve by discontinuing dasatinib. 4

Gastrointestinal Symptoms

Management of gastrointestinal symptoms includes administration of antiemetics and antidiarrheals. 19 10 Dasatinib can reduce intestinal blood flow and impair the function of the intestinal barrier. 15 To improve the function of the intestinal barrier, drugs such as RUS (ruscogenin) can be used. 15

Chylothorax

Management of chylothorax includes chest fluid drainage (thoracentesis) and surgery to repair damaged lymphatic vessels. 2 Dasatinib-induced chylothorax may improve by discontinuing dasatinib. 2

Facial Edema

Management of facial edema includes administration of diuretics and discontinuation of dasatinib. 11

Skin Symptoms

Management of skin symptoms includes application of topical medications such as steroid creams and administration of antihistamines. 10 Dasatinib-induced acneiform eruptions can be treated with drugs such as sarecycline. 3

Other

Management of dasatinib-induced side effects may include discontinuation of dasatinib or reducing the dosage of dasatinib. 10 To reduce side effects of dasatinib, it is necessary to use drugs that prevent or treat side effects in combination with dasatinib. 12 Dasatinib can suppress immune function. 7 Patients taking dasatinib may be more susceptible to infections such as tuberculosis. 7 Dasatinib, when used in combination with anticancer drugs, can worsen side effects. 16 Dasatinib has also been used to treat complications related to CAR-T cell therapy. 14

Comparison Across Studies

Commonalities Across Studies

Many studies have reported that dasatinib can cause side effects such as thrombocytopenia, neutropenia, pleural effusion, and gastrointestinal symptoms. 19 10 Furthermore, many studies have reported that dasatinib can suppress immune function. 7

Differences Across Studies

The incidence and severity of dasatinib side effects vary across studies. This may be influenced by factors such as the age and sex of the study subjects, the type of drug being taken, and the dosage. 19 10 There may also be variations in the management of dasatinib side effects across studies. 19 10

Considerations for Real-World Application

Dasatinib is an effective treatment for chronic myeloid leukemia (CML), but it also carries the risk of side effects. 19 10 If you are taking dasatinib, you should discuss the risks of side effects with your doctor and take appropriate measures to manage side effects if necessary. 19 10 Additionally, dasatinib can suppress immune function. 7 Patients taking dasatinib may be more susceptible to infections such as tuberculosis. 7 You should discuss the risks of infection with your doctor and consider getting vaccinated if necessary. 7

Limitations of Current Research

Research on the side effects of dasatinib is still ongoing and more studies are needed. 19 10 In particular, there is still much that is unknown about the long-term side effects of dasatinib. 10

Future Directions for Research

More research is needed on the side effects of dasatinib. 19 10 In particular, further studies are needed on the long-term side effects of dasatinib, as well as the development of drugs to prevent and treat dasatinib side effects. 19 10

Conclusion

Dasatinib is an effective treatment for chronic myeloid leukemia (CML), but it also carries the risk of side effects. 19 10 If you are taking dasatinib, you should discuss the risks of side effects with your doctor and take appropriate measures to manage side effects if necessary. 19 10 Furthermore, more research is needed on the long-term side effects of dasatinib, as well as the development of drugs to prevent and treat dasatinib side effects. 19 10

Literature analysis of 21 papers
Positive Content
17
Neutral Content
2
Negative Content
2
Article Type
2
0
0
2
16
1.

Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement.

Author: MahrleG, SchulzeH J, FärberL, WeidingerG, SteiglederG K

Nail and joint improvement
Psoriasis treatment
Cyclosporine side effects
Relapse risk

Low-dose short-term cyclosporine therapy was highly effective and well tolerated for psoriasis, compared to etretinate. Remission was better preserved by tapering the drug than by discontinuing treatment abruptly.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Dasatinib-Associated Acneiform Eruption Successfully Treated With Sarecycline in a Patient With Chronic Myeloid Leukemia.

Author: PoplauskyDina, YoungJade N, DubinDanielle P, TremblayDouglas, GulatiNicholas

Acneiform eruption treatment

A case of a patient with chronic myeloid leukemia (CML) who developed an acneiform eruption after taking dasatinib is presented. The eruption was effectively treated with sarecycline, a narrow-spectrum tetracycline. Sarecycline is a potentially safer alternative to doxycycline, especially for long-term use.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

4.

Dasatinib-Induced Bilateral Pleural Effusions.

Author: RasulTaha F, MotoaGabriel, FlowersRobert C

Ascites
Pleural effusions

This case report presents a 60-year-old man with chronic myeloid leukemia (CML) on dasatinib who developed bilateral pleural effusions and ascites. The effusions were attributed to dasatinib therapy, while the ascites was of unclear origin. This case highlights the potential for dasatinib to induce both pleural effusions and ascites.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

5.

Long-term follow-up of lower dose dasatinib (50 mg daily) as frontline therapy in newly diagnosed chronic-phase chronic myeloid leukemia.

Author: NaqviKiran, JabbourElias, SkinnerJeffrey, AndersonKristin, DellasalaSara, YilmazMusa, FerrajoliAlessandra, BosePrithviraj, ThompsonPhilip, AlvaradoYesid, JainNitin, TakahashiKoichi, BurgerJan, EstrovZeev, BorthakurGautam, PemmarajuNaveen, PaulShilpa, CortesJorge, KantarjianHagop M

CML treatment
Improved tolerance
Myelosuppression
Pleural effusions

This study reports the long-term follow-up results of dasatinib at 50 mg daily as frontline therapy for chronic-phase chronic myeloid leukemia (CML-CP). Dasatinib is a potent Bcr-Abl tyrosine kinase inhibitor with known side effects like pleural effusions and myelosuppression. The 50 mg dose showed promising long-term efficacy and better tolerability compared to the standard 100 mg dose.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Short senolytic or senostatic interventions rescue progression of radiation-induced frailty and premature ageing in mice.

Author: FielderEdward, WanTengfei, AlimohammadihaGhazaleh, IshaqAbbas, LowEvon, WeigandB Melanie, KellyGeorge, ParkerCraig, GriffinBrigid, JurkDiana, KorolchukViktor I, von ZglinickiThomas, MiwaSatomi

Improved liver function
Improved muscle function
Improved short-term memory
Reduced frailty progression

This study investigated the impact of anti-senescence interventions on radiation-induced frailty in mice. Short-term treatment with senolytics (Navitoclax or dasatinib + quercetin) or the senostatic metformin effectively reduced frailty progression and improved muscle and liver function as well as short-term memory. These interventions might be beneficial for cancer survivors who experience long-term health effects from radiation exposure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Case reports of chronic myeloid leukemia and tuberculosis: Is imatinib the link between the two?

Author: VermaShailendra Prasad, TripathiAnil Kumar, KumarNidhish, GuptaSuneel Kumar

CML treatment
Tuberculosis

This report highlights three cases of patients with chronic myeloid leukemia (CML) who developed tuberculosis while on treatment with tyrosine kinase inhibitors (TKIs), specifically imatinib or dasatinib. These cases suggest that TKIs may interfere with immune function, potentially increasing the risk of tuberculosis in CML patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Serial evaluation of the pharmacokinetics of ponatinib in patients with CML and Ph + ALL.

Author: KawanoNoriaki, KimuraShinya, MiuraMasatomo, TochigiTaro, NakaikeTakashi, YamashitaKiyoshi, MashibaKoichi, KikuchiIkuo, TakahashiNaoto

CML treatment
Ph+ ALL treatment
Intolerance
Resistance

Ponatinib, a third-generation TKI, was effective in treating CML and Ph + ALL patients intolerant to other TKIs. Serial monitoring of ponatinib pharmacokinetics provided valuable information on its safety and efficacy, enabling personalized treatment adjustments.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Clinical uses and safety concerns of tyrosine kinase inhibitors with a focus on novel drugs: A narrative review.

Author: BoskabadiSeyyed Javad, DashtiAyat, KarevanSara, Kargar-SoleimanabadSaeed, SalehifarEbrahim

Cancer treatment
Cardiovascular issues
Dermatologic effects
Endocrine effects
Gastrointestinal effects
Hematologic effects
Renal effects
Reproductive effects

This article reviews the safety issues surrounding tyrosine kinase inhibitors (TKIs), specifically, hematological adverse effects, cardiovascular issues, renal adverse effects and nephrotoxicity, endocrine system adverse effects, concerns related to the reproductive system, dermatological and gastrointestinal adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Pharmacology of tyrosine kinase inhibitors in chronic myeloid leukemia; a clinician's perspective.

Author: PushpamDeepam, BakhshiSameer

CML treatment

Tyrosine kinase inhibitors (TKIs) are effective in treating chronic myeloid leukemia (CML), with varying pharmacokinetics, pharmacodynamics, and adverse effects. Key phase 3 trials compared different TKIs, highlighting the importance of treatment-free remission and appropriate TKI selection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Facial Edema Associated with Dasatinib: Case Report with Successful Treatment.

Author: NyckowskiTimothy, AmburAustin, VinokurovAlisa, NathooRajiv

TKI side effects

Tyrosine kinase inhibitors (TKI) are effective for chronic myeloid leukemia but can cause side effects, including rare cases of facial edema. This study highlights the importance of managing TKI-related adverse effects, especially facial edema, due to the lifelong nature of treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

A randomized, phase II trial of adjuvant immunotherapy with durable TKI-free survival in patients with chronic phase CML.

Author: WebsterJonathan A, RobinsonTara M, BlackfordAmanda L, WarlickErica, FergusonAnna, BorrelloIvan, ZahurakMarianna, JonesRichard J, SmithB Douglas

CML disease control
TKI discontinuation

Adjuvant immunotherapy with TKIs could facilitate TKI discontinuation in CP-CML patients who achieve undetectable minimal residual disease. This suggests a potential strategy for improving long-term outcomes in CML.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

14.

Dasatinib for treatment of CAR T-cell therapy-related complications.

Author: BaurKatharina, HeimDominik, BeerlageAstrid, PoeringsAnna S, KoppBastian, MedingerMichael, DirksJan C, PasswegJakob R, HolbroAndreas

CRS treatment
ICANS treatment

This report details the successful treatment of a patient with severe cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) with dasatinib, a tyrosine kinase inhibitor. This case suggests a potential new treatment option for severe complications of CAR T-cell therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Ruscogenin ameliorates dasatinib-induced intestinal barrier dysfunction via ErbB4/YAP and ROCK/MLC pathways.

Author: HuangJuan, ZhouJianhao, DaiYujie, LiuYuankai, LiFang, GongShuaishuai, ZhangYuanyuan, KouJunping

Intestinal barrier protection

Ruscogenin (RUS), a compound from the traditional Chinese medicine Ophiopogon japonicas, can protect endothelial microvascular barrier function and potentially mitigate gastrointestinal bleeding caused by dasatinib, a drug used for leukemia treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Recurrent Chylous Pleural Effusions in a Patient Treated With Dasatinib.

Author: NasirSyed Alishan, Calavia LianoHugo, ManfrediChristopher

CML treatment
Chylous effusions
Pleural effusion

This abstract reports a case of a patient who developed recurrent chylous pleural effusion after being treated with dasatinib, a BCR-ABL tyrosine kinase inhibitor. This rare side effect of dasatinib could potentially cause irreversible damage to the lymphatic duct.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

21.

A Case Report of Multiple Capillary Hemangioma in a Chronic Myeloid Leukemia Patient Taking Tyrosine Kinase Inhibitors.

Author: ByunHyun Jeong, JangDonghwi, LeeJongeun, OhSe Jin, LimYoungkyoung, ParkJi-Hye, LeeJong Hee, LeeDong-Youn

Chronic myeloid leukemia treatment
Capillary hemangioma

This case report describes a patient with chronic myeloid leukemia who developed multiple capillary hemangiomas following treatment with tyrosine kinase inhibitors (TKIs). The case suggests that TKIs, which can paradoxically activate the MEK/ERK pathway involved in angiogenesis, may be responsible for the development of these vascular tumors.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

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