title: Incidence, risk factors and management of pleural effusions during dasatinib treatment in unselected elderly patients with chronic myelogenous leukaemia.
abstract: To assess the most important features and clinical impact of pleural effusions, which are a common toxicity during dasatinib treatment and often impair its high efficacy, 172 unselected consecutive patients with chronic myelogenous leukaemia in chronic phase treated in 27 Italian centres, with dasatinib when aged >60 years for resistance/intolerance to imatinib, were examined. During treatment, 52/172 patients (30.2%) presented pleural effusion, which was grades 1-2 in 38 patients and grades 3-4 in 14 patients (8.1% of the entire cohort of patients), according to the WHO scale; in 14/52 patients (26.9%), there was a concomitant pericardial effusion. Pleural effusion was recurrent in 25/52 patients (48.0%). Median time from dasatinib to first pleural effusion was 11.0 months (interquartile range 3.6-18.6). Eleven patients (6.4%) required permanent dasatinib discontinuation. Only presence of concomitant pulmonary disease ( p = 0.035) and initial daily dose of dasatinib (140 mg vs 100 mg, p = 0.014) were significantly associated with pleural effusions. There were no differences among patients with or without pleural effusions as concerns response rates and overall survival. Pleural effusions were common in our unselected 'real-life' population of elderly patients but were clinically manageable and did not seem to affect treatment results.
authors: Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome, Italy. rob.lati@libero.it
authors: Roberto
authors: R
authors: Latagliata
authors: Massimo
authors: M
authors: Breccia
authors: Carmen
authors: C
authors: Fava
authors: Fabio
authors: F
authors: Stagno
authors: Mario
authors: M
authors: Tiribelli
authors: Luigiana
authors: L
authors: Luciano
authors: Antonella
authors: A
authors: Gozzini
authors: Gabriele
authors: G
authors: Gugliotta
authors: Mario
authors: M
authors: Annunziata
authors: Francesco
authors: F
authors: Cavazzini
authors: Dario
authors: D
authors: Ferrero
authors: Pellegrino
authors: P
authors: Musto
authors: Isabella
authors: I
authors: Capodanno
authors: Alessandra
authors: A
authors: Iurlo
authors: Giuseppe
authors: G
authors: Visani
authors: Monica
authors: M
authors: Crugnola
authors: Elisabetta
authors: E
authors: Calistri
authors: Fausto
authors: F
authors: Castagnetti
authors: Paolo
authors: P
authors: Vigneri
authors: Giuliana
authors: G
authors: Alimena
mesh_terms: D000368:Aged; D003582:Cytogenetics; D000069439:Dasatinib; D005260:Female; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000139:chemically induced* / Q000473:pathology*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000069439:Dasatinib