CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2022; 43(02): 216-222
DOI: 10.1055/s-0042-1742334
Case Report with Review of Literature

Unilateral Interstitial Lung Disease with Contralateral Effusion: Unusual Case Report of Dasatinib Toxicity

Maheema Bhaskar
1   Department of Pulmonary Medicine, Tata Memorial hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
Pavankumar Biraris
1   Department of Pulmonary Medicine, Tata Memorial hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
Owais Tisekar
1   Department of Pulmonary Medicine, Tata Memorial hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
Rajiv Kumar Kaushal
2   Department of Pathology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
Amit Janu
3   Department of Radiology, Tata Memorial hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
Sandeep Tandon
1   Department of Pulmonary Medicine, Tata Memorial hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
› Author Affiliations
Funding None.


Dasatinib is a second-generation tyrosine kinase inhibitor (TKI) used in chronic myelogenous leukemia (CML). While pleural effusion due to Dasatinib is well described in the literature, interstitial lung disease (ILD) caused by it is rare. A 60-year-old gentleman was on treatment with 100 mg of tablet Dasatinib per day for chronic myeloid leukemia. He presented to the outpatient department with history of progressive breathlessness over 2 months. High-resolution computerized tomography (HRCT) thorax revealed mild right-sided effusion and non-specific interstitial pneumonia (NSIP) pattern of ILD in the left lower lobe. Thoracocentesis of the right-sided pleural effusion showed exudative and lymphocytic rich pleural effusion. The effusion was negative for malignant cells or infection. Biopsy of the left lower lobe was consistent with the diagnosis of ILD. He was started on prednisolone which was gradually tapered and stopped. At 3 months, there was a complete resolution of the ILD and pleural effusion. Clinicians need to be aware about the pleuroparenchymal toxicities of Dasatinib. Early diagnosis and treatment with steroids can lead to complete resolution of the signs and symptoms.

Declaration of Patient Consent

Patient consent is taken at the time of patient's registration at the Hospital for use of their anonymized data for research purpose.

Sources of Support


Publication History

Article published online:
15 February 2022

© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Nam S, Kim D, Cheng JQ. et al. Action of the Src family kinase inhibitor, dasatinib (BMS-354825), on human prostate cancer cells. Cancer Res 2005; 65 (20) 9185-9189
  • 2 Sakoda Y, Arimori Y, Ueno M, Matsumoto T. A suspected case of an alveolar haemorrhage caused by Dasatinib. Intern Med 2017; 56 (02) 203-206
  • 3 Radaelli F, Bramanti S, Fantini NN, Fabio G, Greco I, Lambertenghi-Deliliers G. Dasatinib-related alveolar pneumonia responsive to corticosteroids. Leuk Lymphoma 2006; 47 (06) 1180-1181
  • 4 Jasielec JK, Larson RA. Dasatinib-related pulmonary toxicity mimicking an atypical infection. J Clin Oncol 2016; 34 (06) e46-e48
  • 5 Montani D, Bergot E, Günther S. et al. Pulmonary arterial hypertension in patients treated by Dasatinib. Circulation 2012; 125 (17) 2128-2137
  • 6 Talpaz M, Shah NP, Kantarjian H. et al. Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias. N Engl J Med 2006; 354 (24) 2531-2541
  • 7 Quintás-Cardama A, Kantarjian H, O'brien S. et al. Pleural effusion in patients with chronic myelogenous leukemia treated with Dasatinib after imatinib failure. J Clin Oncol 2007; 25 (25) 3908-3914
  • 8 Bergeron A, Réa D, Levy V. et al. Lung abnormalities after Dasatinib treatment for chronic myeloid leukemia: a case series. Am J Respir Crit Care Med 2007; 176 (08) 814-818
  • 9 Qiu Z-Y, Xu W, Li J-Y. Large granular lymphocytosis during Dasatinib therapy. Cancer Biol Ther 2014; 15 (03) 247-255
  • 10 Nagata Y, Ohashi K, Fukuda S, Kamata N, Akiyama H, Sakamaki H. Clinical features of dasatinib-induced large granular lymphocytosis and pleural effusion. Int J Hematol 2010; 91 (05) 799-807
  • 11 Suh KJ, Lee JY, Shin D-Y. et al. Analysis of adverse events associated with Dasatinib and nilotinib treatments in chronic-phase chronic myeloid leukemia patients outside clinical trials. Int J Hematol 2017; 106 (02) 229-239
  • 12 Sato M, Watanabe S, Aoki N. et al. A case of drug-induced organizing pneumonia caused by Dasatinib. Gan To Kagaku Ryoho 2018; 45 (05) 851-854
  • 13 Zitnik RJ, Matthay RA. Drug-Induced Lung Disease. 3rd ed. Interstitial Lung Disease. Hamilton, Ontario: Mosby Yearbook; 1998
  • 14 Common Terminology Criteria for Adverse Events (CTCAE). 2017 . Available at:
  • 15 Flaherty KR, Wells AU, Cottin V. et al; INBUILD Trial Investigators. Nintedanib in progressive fibrosing interstitial lung diseases. N Engl J Med 2019; 381 (18) 1718-1727
  • 16 Iurlo A, Galimberti S, Abruzzese E. et al. Pleural effusion and molecular response in Dasatinib-treated chronic myeloid leukemia patients in a real-life Italian multicenter series. Ann Hematol 2018; 97 (01) 95-100
  • 17 Cortes JE, Saglio G, Kantarjian HM. et al. Final 5-year study results of DASISION: the Dasatinib versus imatinib study in Treatment-Naïve Chronic Myeloid Leukemia Patients Trial. J Clin Oncol 2016; 34 (20) 2333-2340
  • 18 Shah NP, Rousselot P, Schiffer C. et al. Dasatinib in imatinib-resistant or -intolerant chronic-phase, chronic myeloid leukemia patients: 7-year follow-up of study CA180-034. Am J Hematol 2016; 91 (09) 869-874
  • 19 Hagihara M, Iriyama N, Yoshida C. et al. Association of pleural effusion with an early molecular response in patients with newly diagnosed chronic-phase chronic myeloid leukemia receiving Dasatinib: results of a D-First study. Oncol Rep 2016; 36 (05) 2976-2982
  • 20 Kantarjian H, Cortes J, Kim D-W. et al. 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 (25) 6322-6329
  • 21 Kim D-W, Saussele S, Williams LA. et al. Outcomes of switching to Dasatinib after imatinib-related low-grade adverse events in patients with chronic myeloid leukemia in chronic phase: the DASPERSE study. Ann Hematol 2018; 97 (08) 1357-1367
  • 22 Cortes J, Kim D-W, Raffoux E. et al. Efficacy and safety of Dasatinib in imatinib-resistant or -intolerant patients with chronic myeloid leukemia in blast phase. Leukemia 2008; 22 (12) 2176-2183
  • 23 Apperley JF, Cortes JE, Kim D-W. et al. Dasatinib in the treatment of chronic myeloid leukemia in accelerated phase after imatinib failure: the START of a trial. J Clin Oncol 2009; 27 (21) 3472-3479
  • 24 Hochhaus A, Baccarani M, Deininger M. et al. Dasatinib induces durable cytogenetic responses in patients with chronic myelogenous leukemia in chronic phase with resistance or intolerance to imatinib. Leukemia 2008; 22 (06) 1200-1206
  • 25 Fox LC, Cummins KD, Costello B. et al. The incidence and natural history of Dasatinib complications in the treatment of chronic myeloid leukemia. Blood Adv 2017; 1 (13) 802-811