title: Spontaneous subdural hematoma in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia with normal platelet count after dasatinib treatment.
abstract: Dasatinib, which is an inhibitor of BCR-ABL and SRC family tyrosine kinases, is used for the treatment of patients with Philadelphia chromosome (Ph) positive leukemia, especially for those who develop resistance or who are intolerant to imatinib. The most common adverse effects attributed to its use are: myelosuppression, nausea, diarrhea, and peripheral edema. Hemorrhage, which could be gastrointestinal, genitourinary or central nervous system, is a less frequent adverse effect. In this case, we report a patient affected by precursor B-cell acute lymphoblastic leukemia (ALL) positive for the Ph chromosome translocation treated with the tyrosine kinase inhibitor (TKI) dasatinib. During the treatment with dasatinib the patient developed subdural hematoma (SDH). She did not have any head trauma, thrombocytopenia, coagulopathy or meningeal involvement, making dasatinib-induced platelet dysfunction the most likely cause of SDH.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, King Hussein Cancer Center , Amman , Jordan , and.
authors.forename: Moaath K
authors.initials: MK
authors.lastname: Mustafa Ali
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Sabha
authors.forename: Kamal H
authors.initials: KH
authors.lastname: Al-Rabi
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D000069439:Dasatinib / Q000627:therapeutic use*; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D010677:Philadelphia Chromosome; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D000069439:Dasatinib
keywords: Acute lymphoblastic leukemia; Philadelphia chromosome; dasatinib; subdural hematoma