Pai Ting-Wei, Huang Cheng-Wei
Department of Medical Education, Changhua Christian Hospital, Changhua, Taiwan.
Division of Hematology/Oncology, Changhua Christian Hospital, Changhua, Taiwan.
Medicine (Baltimore). 2025 Jan 17;104(3):e41328. doi: 10.1097/MD.0000000000041328.
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.
A 43-year-old male patient with CML developed chylothorax after 4 years of low-dose dasatinib.
The patient also developed pulmonary hypertension and pericardial effusion at the same time.
Therapeutic interventions included thoracentesis, steroids, diuretics, and sildenafil. Dasatinib was discontinued and replaced with nilotinib, which resolved the chylothorax, pulmonary hypertension, and pericardial effusion.
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.
Close monitoring for these rare side effects is paramount even in patients on long-term or low-dose dasatinib.
乳糜胸是一种罕见的不良反应，与用于治疗慢性粒细胞白血病（CML）的酪氨酸激酶抑制剂达沙替尼有关。大多数报告的病例描述的是标准剂量。在本病例报告中，我们描述了一名43岁的CML男性患者，在接受低剂量达沙替尼治疗4年后发生了乳糜胸。据我们所知，这是首例报告同时出现肺动脉高压、心包积液和达沙替尼诱导的乳糜胸的病例。
一名43岁的CML男性患者在接受低剂量达沙替尼治疗4年后发生了乳糜胸。
该患者同时还出现了肺动脉高压和心包积液。
治疗干预包括胸腔穿刺术、使用类固醇、利尿剂和西地那非。停用达沙替尼，换用尼罗替尼，这使乳糜胸、肺动脉高压和心包积液得到缓解。
长期低剂量使用达沙替尼会发生乳糜胸。并发肺动脉高压和心包积液虽然不常见，但可能会发生。及时识别、停用达沙替尼和进行治疗干预对于优化治疗结果至关重要。
即使是长期或低剂量使用达沙替尼的患者，密切监测这些罕见副作用也至关重要。
