A narrative review on adverse effects of dasatinib with a focus on pharmacotherapy of dasatinib-induced pulmonary toxicities
Zahra Nekoukar1, Minoo Moghimi1, Ebrahim Salehifar2
1Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, 2Clinical Pharmacy, Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
Correspondence to: Ebrahim Salehifar, Ph.D.
Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Valie-Asr Boulevard, Sari, Mazandaran, Iran
E-mail: Esalehifar@mazums.ac.ir
Published online: November 12, 2021.
© The Korean Journal of Hematology. All rights reserved.

Abstract
Chronic myeloid leukemia (CML), a myeloproliferative disorder caused by the over activity of BCR-ABL1 (breakpoint cluster region-Abelson), has been successfully treated by Tyrosine kinase inhibitors (TKIs). While imatinib is known as the first-line treatment of CML, in some cases other TKIs including dasatinib, nilotinib, bosutinib, and ponatinib may be preferred. Dasatinib, a second-generation TKI, inhibits multiple family kinases including BCR-ABL, SRC family kinases, receptor kinases, and TEC family kinases. It is effective against most imatinib-resistant cases except T315I mutation. Despite the superiority of dasatinib in its hematologic and cytogenetic responses in CML compared to imatinib, its potentially harmful pulmonary complications including pleural effusion (PE) and pulmonary arterial hypertension (PAH) may limit its use. Appropriate management of these serious adverse reactions is critical in both improving the quality of life and the outcome of the patient. In this narrative review, we will scrutinize the pulmonary complications of dasatinib and focus on the management of these toxicities.
Keywords: Dasatinib, Pleural effusion, Pulmonary arterial hypertension, Chronic myeloid leukemia, Pharmacotherapy


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