Case Report of International Journal of Case Reports
Dasatinib-Induced Colitis in a Patient with Chronic Myeloid Leukemia (Chronic Phase)
Lubna M. Riaz1#, Khaled M. Galal2, Radwa M. Hussein2, Abdulqadir J. Nashwan1, Mohamed A. Yassin1#
1. Hematology Section/Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
2. Department of Pharmacy, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Chronic myeloid leukemia (CML) is a Philadelphia (Ph) chromosome-positive myeloproliferative neoplasm. The molecular consequence of reciprocal translocation t(9;22)(q34;q11) is the generation of the BCR–ABL fusion gene, which encodes a constitutively active tyrosine kinase signaling protein. The tyrosine kinase is responsible for the leukemia phenotype through the constitutive activation of multiple signaling pathways involved in the cell cycle and in adhesion and apoptosis. Dasatinib is an oral BCR-ABL tyrosine kinase inhibitor (TKI) which is mainly used for treating CML patients with resistance or intolerance to Imatinib. Dasatinib has several significant adverse reactions and gastrointestinal side effects including colitis. We report a case of a 33-year-old male, diagnosed with CML (Chronic Phase) who received Dasatinib as second-line therapy and developed chronic diarrhea and colitis attributed to Dasatinib and improved after stopping it.
Keywords: Dasatinib, Chronic myeloid leukemia, Colitis
#First and last authors equally contributed
How to cite this article:
Lubna M. Riaz, Khaled M. Galal, Radwa M. Hussein, Abdulqadir J. Nashwan, Mohamed A. Yassin. Dasatinib-Induced Colitis in a Patient with Chronic Myeloid Leukemia (Chronic Phase). International Journal of Case Reports, 2018 3:43. DOI:10.28933/ijcr-2018-10-2401
1. Yassin MA, Moustafa AH, Nashwan AJ, Soliman AT, Derhoubi HE, Mohamed SF, et al. Dasatinib induced avascular necrosis of femoral head in adult patient with chronic myeloid leukemia. Clinical Medicine Insights: Blood Disorders. 2015;8:CMBD. S24628.
2. Yassin MA, Nashwan AJ, Soliman AT, Yousif A, Moustafa A, AlBattah A, et al. Cytomegalovirus-induced hemorrhagic colitis in a patient with chronic myeloid leukemia (chronic phase) on dasatinib as an upfront therapy. Clinical Medicine Insights: Case Reports. 2015;8:CCRep. S25327.
3. Al-Dewik NI, Morsi HM, Samara MM, Ghasoub RS, Gnanam CC, Bhaskaran SK, et al. Is adherence to Imatinib Mesylate treatment among patients with chronic myeloid leukemia associated with better clinical outcomes in Qatar? Clinical Medicine Insights: Oncology. 2016;10:CMO. S32822.
4. Yassin MA, El-Ayoubi HR, Kamzoul RT. Efficacy and safety of Dasatinib 50 mg once daily dose in patients with chronic phase CML who failed IMATINIB. Am Soc Hematology; 2011.
5. Shanshal M, Shakespeare A, Thirumala S, Fenton B, Quick DP. Dasatinib-induced T-cell-mediated colitis: a case report and review of the literature. Acta haematologica. 2016;136(4):219-28.
6. Hochhaus A, Saussele S, Rosti G, Mahon F-X, Janssen J, Hjorth-Hansen H, et al. Chronic myeloid leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2017;28(suppl_4):iv41-iv51.
7. Broekman F, Giovannetti E, Peters GJ. Tyrosine kinase inhibitors: Multi-targeted or single-targeted? World journal of clinical oncology. 2011;2(2):80.
8. Deangelo D. Managing chronic myeloid leukemia patients intolerant to tyrosine kinase inhibitor therapy. Blood cancer journal. 2012;2(10):e95.
9. Christopher LJ, Cui D, Wu C, Luo R, Manning JA, Bonacorsi SJ, et al. Metabolism and disposition of dasatinib after oral administration to humans. Drug Metabolism and Disposition. 2008;36(7):1357-64.
10. Mustjoki S, Laurinolli T, Ekblom M, Rauhala A, Sinisalo M, Almqvist A, et al. Clonal Large Granular Lymphocyte (LGL) Expansion Associated with Dasatinib Therapy. Am Soc Hematology; 2007.
11. Quintás‐Cardama A, Kantarjian H, Ravandi F, O’brien S, Thomas D, Vidal‐Senmache G, et al. Bleeding diathesis in patients with chronic myelogenous leukemia receiving dasatinib therapy. Cancer. 2009;115(11):2482-90.
12. Keskin D, Sadri S, Eskazan AE. Dasatinib for the treatment of chronic myeloid leukemia: patient selection and special considerations. Drug design, development and therapy. 2016;10:3355.
13. Blake SJ, Lyons AB, Fraser CK, Hayball JD, Hughes TP. Dasatinib suppresses in vitro natural killer cell cytotoxicity. Blood. 2008;111(8):4415-6.
14. Schade AE, Schieven GL, Townsend R, Jankowska AM, Susulic V, Zhang R, et al. Dasatinib, a small-molecule protein tyrosine kinase inhibitor, inhibits T-cell activation and proliferation. Blood. 2008;111(3):1366-77.
15. Kmira Z, Nesrine BS, Houneida Z, Wafa BF, Aida S, Yosra BY, et al. Severe hemorrhagic colitis in a patient with chronic myeloid leukemia in the blastic phase after dasatinib use. World journal of gastrointestinal pathophysiology. 2013;4(3):59.
16. Patodi N, Sagar N, Rudzki Z, Langman G, Sharma N. Haemorrhagic colitis caused by dasatinib. Case reports in hematology. 2012;2012.