Dasatinib: A rare cause of recurrent cardiac tamponade

Year 2022, Volume: 39 Issue: 2, 584 - 586, 18.03.2022

Metin Çoksevim , Murat Akçay

Abstract

Dasatinib is one of the second-generation tyrosine kinase inhibitors (TKI) that used as the first line for the treatment of Philadelphia chromosome (Ph) positive chronic myeloid leukemia (CML). Several cardiovascular side effects such as pleural-pericardial effusion, pulmonary hypertension, prolonged QTc interval, and platelet dysfunction have been reported. A 59-year-old female with worsening dyspnoea was diagnosed with cardiac tamponade twice in six months period after initiation of Dasatinib 100 mg per day for CML. She was successfully treated with drainage of effusion percutaneously and discontinuation of Dasatinib. Recurrent cardiac tamponade is a rare complication related to the use of Dasatinib. It should be kept in mind that Dasatinib is a potential agent for pericardial effusion, especially when other possibilities are excluded.

Keywords

Recurrent cardiac tamponade, Dasatinib, Cardiac effects

References

• 1. Yun S, Vincelette ND, Segar JM, Dong Y, Shen Y, Kim DW, et al. Comparative Effectiveness of Newer Tyrosine Kinase Inhibitors Versus Imatinib in the First-Line Treatment of Chronic-Phase Chronic Myeloid Leukemia Across Risk Groups: A Systematic Review and Meta-Analysis of Eight Randomized Trials. Clin Lymphoma Myeloma Leuk. 2016; 16; 6: e85-94.
• 2. Izumi-Nakaseko H, Fujiyoshi M, Hagiwara-Nagasawa M, Goto A, Chiba K, Kambayashi R, et al. Dasatinib can Impair Left Ventricular Mechanical Function But May Lack Proarrhythmic Effect: A Proposal of Non-clinical Guidance for Predicting Clinical Cardiovascular Adverse Events of Tyrosine Kinase Inhibitors. Cardiovasc Toxicol. 2020; 20; 1: 58-70.
• 3. Cortes JE, Saglio G, Kantarjian HM, Baccarani M, Mayer J, Boque C, et al. Final 5-Year Study Results of DASISION: The Dasatinib Versus Imatinib Study in Treatment-Naive Chronic Myeloid Leukemia Patients Trial. J Clin Oncol. 2016;34(20):2333-40.
• 4. Burazor I, Imazio M, Markel G, Adler Y. Malignant pericardial effusion. Cardiology. 2013;124(4):224-32.
• 5. Adler Y, Charron P, Imazio M, Badano L, Baron-Esquivias G, Bogaert J, et al. [2015 ESC Guidelines for the diagnosis and management of pericardial diseases]. Kardiol Pol. 2015;73(11):1028-91.
• 6. Wattal S, Rao MS, Chandra GN, Razak UK, Shetty KR. Dasatinib Induced Cardiac Tamponade-A Rare Association. J Clin Diagn Res. 2017;11(2):Fd03-fd4.
• 7. Krauth MT, Herndlhofer S, Schmook MT, Mitterbauer-Hohendanner G, Schlogl E, Valent P. Extensive pleural and pericardial effusion in chronic myeloid leukemia during treatment with dasatinib at 100 mg or 50 mg daily. Haematologica. 2011;96(1):163-6.
• 8. Jabbour E, Kantarjian HM, Saglio G, Steegmann JL, Shah NP, Boque C, et al. Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION). Blood. 2014;123(4):494-500.
• 9. Moslehi JJ, Deininger M. Tyrosine Kinase Inhibitor-Associated Cardiovascular Toxicity in Chronic Myeloid Leukemia. J Clin Oncol. 2015;33(35):4210-8.
• 10. Cortes JE, Jimenez CA, Mauro MJ, Geyer A, Pinilla-Ibarz J, Smith BD. Pleural Effusion in Dasatinib-Treated Patients With Chronic Myeloid Leukemia in Chronic Phase: Identification and Management. Clin Lymphoma Myeloma Leuk. 2017;17(2):78-82.
• 11. Kelly K, Swords R, Mahalingam D, Padmanabhan S, Giles FJ. Serosal inflammation (pleural and pericardial effusions) related to tyrosine kinase inhibitors. Target Oncol. 2009;4(2):99-105.
• 12. Latagliata R, Breccia M, Fava C, Stagno F, Tiribelli M, Luciano L, et al. Incidence, risk factors and management of pleural effusions during dasatinib treatment in unselected elderly patients with chronic myelogenous leukaemia. Hematol Oncol. 2013;31(2):103-9.
• 13. Masiello D, Gorospe G, 3rd, Yang AS. The occurrence and management of fluid retention associated with TKI therapy in CML, with a focus on dasatinib. J Hematol Oncol. 2009;2:46.
• 14. Mauro MJ, Deininger MW. Management of drug toxicities in chronic myeloid leukaemia. Best Pract Res Clin Haematol. 2009; 22; 3: 409-29.