Paul Theresa, Ellahie Anil Yousaf, Almohtasib Yazan Salah, Sinha Urshita, El Omri Halima
Department of Internal Medicine Hamad Medical Corporation Doha Qatar.
Department of Hematology National Centre for Cancer Care and Research Doha Qatar.
EJHaem. 2021 May 18;2(3):545-550. doi: 10.1002/jha2.226. eCollection 2021 Aug.
Tyrosine kinase inhibitors (TKIs) are the key agents for treating CML and BCR-ABL B-ALL. Dasatinib is a potent second-generation TKI. Here, we have discussed the case of a 51-year-old gentleman diagnosed with B-myeloid mixed-phenotype acute leukemia with t(9;22)(q34.1;q11.2); BCR-ABL1p210, in complete hematological, cytogenetic, and molecular remission, who developed chylothorax. Though pleural effusion is a commonly observed adverse effect of dasatinib therapy, chylothorax is rare. The ability of Dasatinib to inhibit multiple families of tyrosine kinases could be considered the etiology. Discontinuation of the drug resolved the symptom, but pleural effusion recurred once Dasatinib was resumed. Chylothorax induced by Dasatinib is a differential to be kept in mind, owing to the limited number of cases being reported.
酪氨酸激酶抑制剂（TKIs）是治疗慢性粒细胞白血病（CML）和BCR-ABL B淋巴细胞白血病（B-ALL）的关键药物。达沙替尼是一种强效的第二代TKI。在此，我们讨论了一例51岁男性患者的病例，该患者被诊断为伴有t(9;22)(q34.1;q11.2)；BCR-ABL1 p210的B髓系混合表型急性白血病，处于完全血液学、细胞遗传学和分子学缓解状态，却发生了乳糜胸。虽然胸腔积液是达沙替尼治疗常见的不良反应，但乳糜胸却很罕见。达沙替尼抑制多个酪氨酸激酶家族的能力可被视为病因。停药后症状得到缓解，但恢复使用达沙替尼后胸腔积液复发。由于报道的病例数量有限，达沙替尼诱导的乳糜胸是需要牢记的鉴别诊断。
