A 40-year-old man presents with fatigue, night sweats, and massive splenomegaly extending to the pelvis. Peripheral blood shows leukocytosis with granulocytes at all stages of maturation, basophilia, and a low leukocyte alkaline phosphatase score. BCR-ABL1 p210 is detected. The patient is started on dasatinib. Which unique toxicity distinguishes dasatinib from imatinib?
- A Nausea and diarrhea
- B Peripheral edema
- C Pleural effusion ✓
- D Myelosuppression
Correct answer: C. Pleural effusion
Explanation
Dasatinib, a second-generation BCR-ABL TKI, is uniquely associated with pleural effusions (and less commonly pericardial effusions), occurring in up to 28-35% of patients. This is not typical of imatinib. Peripheral edema, nausea, diarrhea, and myelosuppression are class effects shared with imatinib. Pleural effusion is the distinguishing toxicity that requires dose modification or diuretic management and is a key differentiating point in clinical practice and examinations.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.