CRA61 DASATINIB INDUCED CHYLOTHORAX IN CHRONIC MYELOID LEUKAEMIA

Noor Eliana Rozani 1, Mohd Aidil Razahli 1, Raymund Dass1, Han Loong Tan1
1 Respiratory Unit, Department of Internal Medicine, Hospital Tuanku Ja’afar Seremban, Malaysia

INTRODUCTION

Chylothorax refers to the presence of chyle in pleural space and it is associated with high morbidity and mortality. This is a unique case of recurrent with dasatinib-induced chylothorax. 

CASE REPORT

A 37-year-old Chinese gentleman with underlying Chronic Myeloid Leukemia (CML) on dasatinib initially admitted for Right Middle Cerebral Artery Infarct. During admission, there was incidental finding of bilateral pleural effusion which is worse on the left side. Left pleural tapping was done which 1.5 litres of pinkish cloudy fluid aspirated and showed exudative pleural effusion. He was referred to respiratory team for recurrent pleural effusion. Pleuroscopy was done and 3 litres of hemoserous fluid was drained and showed multiple areas of whitish plaques at the posterior aspect of intercostal pleura. Pleural biopsy from the whitish plaque was negative for malignancy and pleural fluid ADA was negative. However the pleural fluid analysis established the diagnosis of chylothorax which the pleural fluid cholesterol was 1.37 mmol/L and pleural fluid triglycerides of 4.05mmol/L. This patient was treated with discontinuation of dasatinib and was discharged well with no recurrent of pleural effusion after discontinuation. 

CONCLUSION

This case demonstrates evidence of chylothorax secondary to dasatinib use. Etiology was presumed following resolution of pleural effusion with dasatinib discontinuation. This case highlights a unique etiology of chylothorax and rare adverse reaction secondary to dasatinib therapy.