• Shun Tsuchiya, Tomoiku Takaku, Naoki Watanabe, Noriyoshi Iriyama, Yuta Kimura, Eisaku Iwanaga, Kei-Ji Sugimoto, Toru Mitsumori, Maho Ishikawa, Tomonori Nakazato, Hiroyuki Fujita, Eriko Sato, Yoshihiro Hatta, Norio Asou, Masahiro Kizaki, Michihide Tokuhira, Miki Ando, and Tatsuya Kawaguchi.
• Department of Hematology, Juntendo University School of Medicine, Japan.
• Intern. Med. 2023 Nov 15; 62 (22): 329933033299-3303.

AbstractObjective Pleural effusion (PE) is a common adverse event that occurs during dasatinib therapy for chronic myeloid leukemia (CML). However, the pathomechanism of PE and appropriate management of Asian patients with CML have not been elucidated. This study investigated the incidence rate, risk, and appropriate management of PE in Asian patients with CML treated with dasatinib. Methods We retrospectively collected data on patients in the chronic phase of CML who received first-line dasatinib therapy and were registered in the CML-Cooperative Study Group database. Patients We identified 44 cases of PE in a series of 89 patients and analyzed previously reported risk factors and effective management of PE. Results A univariate analysis revealed that age, diabetes mellitus, chronic renal failure, hypertension, the history of cardiovascular events, and dasatinib dose were significantly associated with PE. A multivariate analysis revealed that age ≥65 years old was the only independent risk factor for PE. Dasatinib dose reduction and switching to a tyrosine kinase inhibitor showed a statistically significant difference in effectively reducing PE volume compared to single diuretic use. Conclusion Although further studies are warranted, our observations showed that advanced age is a significant risk factor for PE, and tyrosine kinase inhibitor dose reduction or replacement of dasatinib may be an effective management strategy for PE in Asian CML patients who received first-line treatment with dasatinib in real-world clinical practice.

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