Pulmonary arterial hypertension (PAH) is a rare but recognized adverse effect of tyrosine kinase inhibitors, notably Dasatinib, prescribed in chronic myeloid leukemia (CML). Due to potential reversibility, prompt recognition and management are essential. We report a 60-year-old male receiving Dasatinib for CML who presented with NYHA class IV dyspnea. Echocardiography showed severe right ventricular dilation and elevated pulmonary pressures. Right heart catheterization confirmed precapillary PAH. Other causes were ruled out. Following discontinuation of Dasatinib and initiation of combination PAH-specific therapy (epoprostenol, bosentan, tadalafil), the patient demonstrated clinical and hemodynamic improvement.This case highlights the need for vigilance in patients on Dasatinib, especially when respiratory symptoms arise. Early intervention can improve outcomes in drug-induced PAH.
Hamady et al. (Wed,) studied this question.