Dasatinib-induced chylothorax in a patient with chronic myeloid leukemia: A Case Report
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Pneumonology Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Pneumon 2018;31(3):183–186
We report the case of a 51-year old man suffering from chronic myeloid leukemia for the past 20 years who presented in our department with a newly onset of cough and shortness of breathing. A chest X-ray revealed bilateral pleural effusions. A diagnostic thoracentesis under ultrasound guidance was performed and the fluid analysis revealed a high concentration of triglycerides both at the right (927 mg/dl) and left side (1,232 mg/dl). Based on Light’s criteria the fluid was classified as an exudate with a predominance of lymphocytes at both sides. For the last 7 years, the patient was treated with dasatinib, an oral tyrosine kinase inhibitor which is associated with plenty of cases of chylotoraces in the literature. Dasatinib was stopped and the patient underwent strict dietary restrictions with oral fastening and parenteral nutrition. A new chest-X ray 2 months later revealed a fast completely remission of the effusions.
Morabito J, Bell MT, Montenij LJ, et al. Perioperative Considerations for Chylothorax. J Cardiothorac Vasc Anesth 2017;31:2277- 81.
Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg 2007;32:362–9.
Valentine VG, Raffin TA. The management of chylothorax. Chest 1992;102:586–91.3.
Zulfiqar QB, Shabber AA, Hammad Bhatti, Braver Y, Sayed K. Ali. Dasatinib-induced chylothorax in chronic myeloid leukemia. Proc (Bayl Univ med Cent) 2017; 30:71–3.
Lucia F, Esther S-J, Juan S-A, Luis V. Dasatinib-induced pleural effusion: Chylothorax, an option to consider. Ann Thorac Med 2016;11:289-93.
Novartis Pharmaceuticals Corporation. Nilotinib prescribing information. East Hanover, NJ: Novartis; 2007 Available at accessed October 24, 2016.
Kantarjian H, Cortes J, Kim DW, Dorlhiac-Llacer P, Pasquini R, DiPersio J. Phase 3 study of dasatinib 140 mg once daily versus 70 mg twice daily in patients with chronic myeloid leukemia in accelerated phase resistant or intolerant to imatinib: 15-month median follow-up. Blood 2009;113:6322-9.
Brixey AG, Light RW. Pleural effusions due to dasatinib. Curr Opin Pulm Med 2010;16:351–6.