Pleural effusion in patients with chronic myelogenous leukemia treated with dasatinib after imatinib failure

Alfonso Quintás-Cardama, Hagop Kantarjian, Susan O'Brien, Gautham Borthakur, John Bruzzi, Reginald Munden, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Purpose: We investigated the risk factors and management of pleural effusion associated with dasatinib therapy for chronic myelogenous leukemia (CML) after failure of imatinib. Patients and Methods: We analyzed 138 patients with CML treated with dasatinib from November 2003 to January 2006 in one phase I (n = 50) and four phase II (n = 88) studies for the development of pleural effusion. Results: Pleural effusion occurred in 48 patients (35%; grade 3/4 in 23 [17%]), including 29% of those treated in chronic phase (CP), 50% in accelerated phase (AP), and 33% in blast phase (BP). By multivariate analysis, history of cardiac disease, hypertension, and use of a twice-daily schedule (v once daily) were identified as factors associated with development of pleural effusions. Effusions were exudative in 78% of the assessable cases. In some patients, effusions were associated with reversible increments of right ventricular systolic pressure. Management included transient dasatinib interruption in 83%, diuretics in 71%, pulse steroids in 27%, and thoracentesis in 19% of patients. Conclusion: Pleural effusions occur during dasatinib therapy, particularly among patients in AP or BP. A twice-daily schedule may result in a higher incidence of pleural effusion. Close monitoring and timely intervention may allow patients to continue therapy and achieve the desired clinical benefit.

Original languageEnglish (US)
Pages (from-to)3908-3914
Number of pages7
JournalJournal of Clinical Oncology
Volume25
Issue number25
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

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Pleural Effusion
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Blast Crisis
Appointments and Schedules
Risk Management
Ventricular Pressure
Imatinib Mesylate
Dasatinib
Diuretics
Heart Diseases
Therapeutics
Multivariate Analysis
Steroids
Blood Pressure
Hypertension
Incidence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Pleural effusion in patients with chronic myelogenous leukemia treated with dasatinib after imatinib failure. / Quintás-Cardama, Alfonso; Kantarjian, Hagop; O'Brien, Susan; Borthakur, Gautham; Bruzzi, John; Munden, Reginald; Cortes, Jorge.

In: Journal of Clinical Oncology, Vol. 25, No. 25, 01.09.2007, p. 3908-3914.

Research output: Contribution to journalArticle

Quintás-Cardama, A, Kantarjian, H, O'Brien, S, Borthakur, G, Bruzzi, J, Munden, R & Cortes, J 2007, 'Pleural effusion in patients with chronic myelogenous leukemia treated with dasatinib after imatinib failure', Journal of Clinical Oncology, vol. 25, no. 25, pp. 3908-3914. https://doi.org/10.1200/JCO.2007.12.0329
Quintás-Cardama, Alfonso ; Kantarjian, Hagop ; O'Brien, Susan ; Borthakur, Gautham ; Bruzzi, John ; Munden, Reginald ; Cortes, Jorge. / Pleural effusion in patients with chronic myelogenous leukemia treated with dasatinib after imatinib failure. In: Journal of Clinical Oncology. 2007 ; Vol. 25, No. 25. pp. 3908-3914.
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