Successful dasatinib therapy in newly diagnosed chronic myeloid leukemia in the setting of short bowel syndrome

J Oncol Pharm Pract. 2023 Sep;29(6):1489-1493. doi: 10.1177/10781552231173441. Epub 2023 May 8.

Abstract

Introduction: There is limited guidance on the selection of tyrosine kinase inhibitors (TKIs) in patients with short bowel syndrome (SBS). Concerns regarding absorption, toxicity profiles, and drug interactions should be considered when selecting optimal TKI therapy.

Case report: A 57-year-old male with SBS was newly diagnosed with chronic myeloid leukemia (CML). A careful review of his surgical history, comorbidities, and concurrent medications led to a treatment decision to initiate dasatinib at 100 mg once daily.

Management and outcome: After initiation of therapy, the patient achieved a complete hematological response after two weeks and an early major molecular response on a three-month assessment. The therapy was tolerated well with no identified adverse effects.

Discussion: Clinical rationale for selecting dasatinib in patients with SBS includes supporting literature regarding its pharmacokinetic absorption characteristics, its efficacy with lower doses in newly diagnosed patients with CML, and its side effect profile in comparison to other second-generation TKIs. The case discussed provides an example of successful therapy in a patient with SBS undergoing treatment for CML.

Keywords: BCR-ABL1; Chronic myeloid leukemia; dasatinib; short bowel syndrome; tyrosine kinase inhibitors.

Publication types

  • Case Reports

MeSH terms

  • Dasatinib / adverse effects
  • Fusion Proteins, bcr-abl
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Male
  • Middle Aged
  • Protein Kinase Inhibitors / adverse effects
  • Short Bowel Syndrome* / drug therapy

Substances

  • Dasatinib
  • Protein Kinase Inhibitors
  • Fusion Proteins, bcr-abl