[A case report of refractory pleural effusion associated with dasatinib in the treatment of chronic myeloied leukemia].

Objective: To study the clinical features and prognosis of pleural effusion associated with dasatinib in treatment of chronic myeloid leukemia(CML).
Methods: A 49 year old mal patient with CML who suffered pleural effusion(grade 3) associated with dasatinib was analyzed and summarized.
Results: the patient achieved complete molecular response(CMR) after treating with dasatinib 100 mg once daily for 3 months. However, the symptom of chest distress occured in the patient after dasatinib treatment for 6 months, the chest CT scan showed bilateral pleural effusion(grade 3), the pleural effusion related with dasatinib was diagnosed, therefore the diuretic and steriod drugs were given, thoracocentesis was also used to relieve the symptom, after treatment for 5 weeks the pleural effusion disappeared, but the pleural effusion recurred when the patient taken dasatinib again, thus the dasatimib was permanently discontinued, but the patient was in CMR. Six months later, the patient began to take Imatinib (first TKI) 300 mg/d, good effects were achieved and no serious adverse effects were observed. Up to now, the patient still is in CMR for 20 months.
Conclusion: In the treatment of CML, appropriate TKI should be chose according to basic disease, and pleural effusion is one of the most common adverse effects during the therapy with dasatinib, close monitoring and timely intervention are necessary. For these patients who were intolerable to recieve the dasatinib, the conversion to another TKI may acquire satisfactory curative effect with tolerance of patients.