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\nby overactivity of BCR-ABL1 (breakpoint cluster region-Abelson) has been\nsuccessfully treated by Tyrosine kinase inhibitors (TKIs). While\nimatinib is known as the first-line treatment of CML, in some cases\nother TKIs including dasatinib, nilotinib, bosutinib, and ponatinib may\nbe preferred. Dasatinib, a second-generation TKI, inhibits multiple\nfamily kinases including BCR-ABL, SRC family kinases, receptor kinases,\nand TEC family kinases. It is effective against most imatinib-resistant\ncases except T315I mutation. Despite the superiority of dasatinib in CML\nhematologic and cytogenetic responses compared to imatinib, its\npotentially harmful pulmonary complications including pleural effusion\n(PE) and pulmonary arterial hypertension (PAH) may limit its use.\nAppropriate management of these serious adverse reactions is critical in\nboth improving the quality of life and outcome of patients. In this\nnarrative review, we will scrutinize the pulmonary complications of\ndasatinib and focus on the management of these toxicities.