, Volume 95, Issue 5, pp 585-587
Date: 09 Mar 2012

Bilateral subdural hemorrhage as a serious adverse event of dasatinib in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia

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Dasatinib has been approved for the treatment of Philadelphia chromosome (Ph)-positive malignancies such as acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML) [14]. Dasatinib had 325-fold greater potency than imatinib mesylate (IM) in cells transduced with unmutated BCR-ABL [5]. Despite its favorable toxicity profile, adverse events associated with dasatinib include myelosuppression, pleural effusion, diarrhea, and liver enzyme abnormalities. Of these, bleeding has been reported in 26–40 % of patients with CML or Ph-positive ALL receiving dasatinib [6, 7]. Most dasatinib-induced bleeding occurs in the gastrointestinal tract, whereas bleeding in the central nervous system is a rare event.

Here, we describe a recurrent Ph-positive ALL patients with moderate thrombocytopenia who developed bilateral subdural hemorrhage (SDH) following dasatinib therapy.

A 58-year-old woman had been diagnosed with Ph-positive ALL approximately 8 months prior, and received induction chemoth