A Narrative Review on Adverse Effects of Dasatinib With a Focus on
Pharmacotherapy of Dasatinib-Induced Pulmonary Toxicities
Abstract
Chronic myeloid leukemia (CML), a myeloproliferative disorder, is caused
by overactivity of BCR-ABL1 (breakpoint cluster region-Abelson) has been
successfully treated by Tyrosine kinase inhibitors (TKIs). While
imatinib is known as the first-line treatment of CML, in some cases
other TKIs including dasatinib, nilotinib, bosutinib, and ponatinib may
be preferred. Dasatinib, a second-generation TKI, inhibits multiple
family kinases including BCR-ABL, SRC family kinases, receptor kinases,
and TEC family kinases. It is effective against most imatinib-resistant
cases except T315I mutation. Despite the superiority of dasatinib in CML
hematologic and cytogenetic responses compared to imatinib, its
potentially harmful pulmonary complications including pleural effusion
(PE) and pulmonary arterial hypertension (PAH) may limit its use.
Appropriate management of these serious adverse reactions is critical in
both improving the quality of life and outcome of patients. In this
narrative review, we will scrutinize the pulmonary complications of
dasatinib and focus on the management of these toxicities.