title: Serosal inflammation (pleural and pericardial effusions) related to tyrosine kinase inhibitors.
abstract: Tyrosine kinase inhibitors (TKIs) have dramatically changed the treatment of chronic myeloid leukemia (CML) and are increasingly used in other malignancies. Despite the apparent selectivity of these agents significant side effects can occur mainly due to off target kinase inhibition. Clinical consequences of serosal inflammation, including pleural and pericardial effusions, have emerged as a frequent adverse event associated with dasatinib while occurring much less frequently during imatinib and nilotinib therapy. The pathogenesis is uncertain but may involve inhibition of platelet derived growth factor or expansion of cytotoxic T and natural killer cells. The development of serosal inflammation with dasatinib poses a significant challenge to physicians, as it cannot be predicted, the time of onset is variable, and management frequently requires repeat invasive procedures.
authors.affiliation: Institute for Drug Development, Cancer Therapy and Research Center, The University of Texas Health Science Center, San Antonio, TX, USA. KellyKR@uthscsa.edu
authors.forename: Kevin
authors.initials: K
authors.lastname: Kelly
authors.forename: Ronan
authors.initials: R
authors.lastname: Swords
authors.forename: Devalingam
authors.initials: D
authors.lastname: Mahalingam
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Giles
mesh_terms: D001549:Benzamides; D049109:Cell Proliferation / Q000187:drug effects; D003602:Cytotoxicity, Immunologic / Q000187:drug effects / Q000276:immunology; D000069439:Dasatinib; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008213:Lymphocyte Activation / Q000187:drug effects; D010490:Pericardial Effusion / Q000209:etiology / Q000517:prevention & control; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D010996:Pleural Effusion / Q000209:etiology / Q000517:prevention & control; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D020797:Receptor, Platelet-Derived Growth Factor beta / Q000037:antagonists & inhibitors*; D012700:Serositis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; D020797:Receptor, Platelet-Derived Growth Factor beta; C498826:nilotinib; D000069439:Dasatinib