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PREVALENCE AND MANAGEMENT OF DASATINIB-INDUCED GASTROINTESTINAL DISORDERS: A STUDY AT OUR HOSPITAL

Yoshiharu Yamaguchi 1, Miyu Oshika 1, Takara Ichidayama 1, Midori Oshima 1, Takashi Tashiro 1, Shunsuke Kato 1, Masaaki Takayama 1, Kazuhiro Yamamoto 1, Yasuhiro Tamura 1, Masahide Ebi 1, Naotaka Ogasawara 1, Makoto Sasaki 1, Kunio Kasugai 1

Affiliations

1 Aichi Medical University School of Medicine, Nagakute, Japan

Summary

AI Generated

Retrospective study of 26 patients receiving dasatinib for chronic myeloid leukemia found frequent gastrointestinal symptoms and endoscopic abnormalities, including occult bleeding in nine cases and colonic mucosal changes in most patients who underwent colonoscopy.

Among 26 patients treated with dasatinib (median duration 48 months), gastrointestinal symptoms included chronic diarrhea in 4 cases, bloody stools in 3 cases, and occult gastrointestinal bleeding in 9 cases.
Colonoscopy in 13 patients revealed rough mucosa in the right colon in 10 patients, with one case showing pseudomembranous colitis-like findings and two cases showing inflammatory polypoid-like findings.
Hemoglobin decreased from 13.1±2.2 before treatment to 12.3±1.1 after one year (change -0.8, p=0.08), suggesting a trend toward anemia.
Non-gastrointestinal adverse events included pleural effusion in 10 cases, hematotoxicity in 8 cases, and edema in 7 cases.
The authors suggest that drug-induced enteritis due to dasatinib should be considered as a differential diagnosis when evaluating gastrointestinal symptoms in patients receiving this medication.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Dasatinib is a medication that inhibits the protein kinase activity of BCR-ABL chimeric protein and is used to treat chronic myeloid leukemia. However, reports of bleeding complications such as gastrointestinal bleeding have been reported despite its therapeutic effects.

Aims & Methods

To investigate the gastrointestinal symptoms and endoscopic findings associated with dasatinib administration.
We retrospectively reviewed medical records of 26 patients who received dasatinib for chronic myeloid leukemia or Philadelphia chromosome-positive acute lymphocytic leukemia at our hospital from July 2017 to June 2022. Patients with a history of dasatinib treatment for less than 1 year or bacterial or cytomegalovirus enteritis were excluded. We examined the duration of dasatinib treatment, adverse events including bloody stools, and endoscopic findings in 13 patients who underwent colonoscopy.

Results

The male-to-female ratio was 19:7, and the median age was 54.5 years (4-84). The median duration of dasatinib treatment was 48 months (12-132). Adverse events included edema (7 cases), pleural effusion (10 cases), rash (2 cases), hematotoxicity (8 cases), and muscle pain (2 cases). Gastrointestinal symptoms included chronic diarrhea (4 cases), gastric discomfort (2 cases), abdominal pain (1 case), and bloody stools (3 cases). Nine cases had occult gastrointestinal bleeding. The change in hemoglobin level from before to 1 year after treatment was -0.8, indicating a decreasing trend (13.1±2.2 before treatment, 12.3±1.1 after treatment; p=0.08). Colonoscopy findings included normal in 2 of the 13 patients, rough mucosa in the right colon in 10 patients, and total colitis in 1 patient. One case showed pseudomembranous colitis-like findings, and 2 cases showed inflammatory polypoid-like findings (1 case of solitary polyp and 1 case of polypoidosis).

Conclusion

Dasatinib has been associated with lower gastrointestinal bleeding, and its excretion in feces is thought to be one of the contributing factors. Various gastrointestinal disorders observed in this study are also suspected to be adverse reactions to the medication. Some cases had endoscopic findings suggestive of pseudomembranous colitis or inflammatory polypoid-like changes, requiring consideration of drug-induced enteritis due to dasatinib as a differential diagnosis.

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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