Resistant Bilateral Chylous Effusion as a Late Adverse Effect of Dasatinib Treatment in Chronic Myeloid Leukaemia

Pleural effusion is a common adverse effect of dasatinib, but chylous effusion is rarely reported. Herein, the authors report the case of a 21-year-old imatinib-resistant patient who presented with bilateral massive chylous effusion on Month 44 of dasatinib treatment. The patient was managed with dasatinib withdrawal, bilateral thorax tube insertion, nasal oxygen support, diuretics, corticosteroids, a fat and oil free diet, and sandostatin. The patient required total parenteral nutrition and albumin infusion. The patient’s right lung collapsed as a result of pleural thickening. A subsequent switch to nilotinib was well tolerated. The authors highlight that patients on dasatinib treatment must be carefully followed for adverse effects.