Low-dose dasatinib-induced chylothorax, pulmonary hypertension, and pericardial effusion in a patient with chronic myeloid leukemia: A case report and literature review.

RATIONALE

Chylothorax is a rare adverse effect that is associated with dasatinib, a tyrosine kinase inhibitor administered for chronic myeloid leukemia (CML) treatment. Most reported cases have described standard dosing. In this case report, we described a 43-year-old male patient with CML who developed chylothorax after 4 years of low-dose dasatinib therapy. To the best of our understanding, this is the first case to report the simultaneous development of pulmonary hypertension, pericardial effusion, and dasatinib-induced chylothorax.

PATIENT CONCERNS

A 43-year-old male patient with CML developed chylothorax after 4 years of low-dose dasatinib.

DIAGNOSES

The patient also developed pulmonary hypertension and pericardial effusion at the same time.

INTERVENTIONS

Therapeutic interventions included thoracentesis, steroids, diuretics, and sildenafil. Dasatinib was discontinued and replaced with nilotinib, which resolved the chylothorax, pulmonary hypertension, and pericardial effusion.

OUTCOMES

Chylothorax occurs with long-term and low-dose dasatinib administration. Concurrent pulmonary hypertension and pericardial effusion, although infrequent, may occur. Prompt recognition, dasatinib discontinuation, and therapeutic interventions are crucial for optimizing outcomes.

LESSONS

Close monitoring for these rare side effects is paramount even in patients on long-term or low-dose dasatinib.