Dasatinib-Induced Chylothorax- A Rare Case

Dasatinib is an efficacious and highly potent second-generation oral tyrosine kinase inhibitor used in the therapy of Philadelphia chromosome-positive acute lymphoblastic leukaemia (ALL) or BCR-ABL-positive chronic myeloid leukaemia (CML). Pulmonary complications are commonly seen with Dasatinib therapy out of which pleural effusion is the most frequent finding. Pleural effusion in these cases is caused secondary to fluid retention, however, chylothorax causing pleural effusion is exceptionally rare. A 58-year-old man treated with second-line Dasatinib for CML presented to us with Empyema thoracis for a chest tube insertion. Thoracentesis showed thick dirty haemorrhagic aspirate, which was then inferred as chylothorax by cholesterol and triglyceride concentrations. After the exclusion of other common causes, drug-induced chylothorax was confirmed. Dasatinib was stopped, a short course of prednisolone was given and the chylothorax resolved. A substitute drug as suggested by the haematologist was started. There was no reoccurrence of pleural effusion.