Serosal inflammation (pleural and pericardial effusions) related to tyrosine kinase inhibitors

Kevin Kelly; Ronan Swords; Devalingam Mahalingam; Swaminathan Padmanabhan; Francis J Giles

doi:10.1007/s11523-009-0110-4

Serosal inflammation (pleural and pericardial effusions) related to tyrosine kinase inhibitors

Target Oncol. 2009 Apr;4(2):99-105. doi: 10.1007/s11523-009-0110-4. Epub 2009 Apr 21.

Authors

Kevin Kelly¹, Ronan Swords, Devalingam Mahalingam, Swaminathan Padmanabhan, Francis J Giles

Affiliation

¹ Institute for Drug Development, Cancer Therapy and Research Center, The University of Texas Health Science Center, San Antonio, TX, USA. KellyKR@uthscsa.edu

PMID: 19381453
DOI: 10.1007/s11523-009-0110-4

Abstract

Tyrosine kinase inhibitors (TKIs) have dramatically changed the treatment of chronic myeloid leukemia (CML) and are increasingly used in other malignancies. Despite the apparent selectivity of these agents significant side effects can occur mainly due to off target kinase inhibition. Clinical consequences of serosal inflammation, including pleural and pericardial effusions, have emerged as a frequent adverse event associated with dasatinib while occurring much less frequently during imatinib and nilotinib therapy. The pathogenesis is uncertain but may involve inhibition of platelet derived growth factor or expansion of cytotoxic T and natural killer cells. The development of serosal inflammation with dasatinib poses a significant challenge to physicians, as it cannot be predicted, the time of onset is variable, and management frequently requires repeat invasive procedures.

Publication types

Review

MeSH terms

Benzamides
Cell Proliferation / drug effects
Cytotoxicity, Immunologic / drug effects
Cytotoxicity, Immunologic / immunology
Dasatinib
Humans
Imatinib Mesylate
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
Lymphocyte Activation / drug effects
Pericardial Effusion / etiology
Pericardial Effusion / prevention & control
Piperazines / administration & dosage
Piperazines / adverse effects
Pleural Effusion / etiology
Pleural Effusion / prevention & control
Protein Kinase Inhibitors / adverse effects*
Protein Kinase Inhibitors / therapeutic use
Protein-Tyrosine Kinases / antagonists & inhibitors
Pyrimidines / administration & dosage
Pyrimidines / adverse effects*
Receptor, Platelet-Derived Growth Factor beta / antagonists & inhibitors*
Serositis / chemically induced*
Serositis / complications
Serositis / diagnosis
Serositis / immunology
Thiazoles / administration & dosage
Thiazoles / adverse effects*
Treatment Outcome

Substances

Benzamides
Piperazines
Protein Kinase Inhibitors
Pyrimidines
Thiazoles
Imatinib Mesylate
Protein-Tyrosine Kinases
Receptor, Platelet-Derived Growth Factor beta
nilotinib
Dasatinib