Spontaneous subdural hematoma in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia with normal platelet count after dasatinib treatment

• Published in: Platelets (Edinburgh) Vol. 26; no. 5; pp. 491 - 494
• Main Authors: Mustafa Ali, Moaath K., Sabha, Marwa M., Al-Rabi, Kamal H.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.07.2015
• Subjects: Antineoplastic Agents - therapeutic use; Brain - pathology; Dasatinib - therapeutic use; Female; Hematoma, Subdural - diagnosis; Hematoma, Subdural - etiology; Hematoma, Subdural - therapy; Humans; Philadelphia Chromosome; Platelet Count; Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Protein Kinase Inhibitors - therapeutic use; Treatment Outcome; subdural hematoma; dasatinib; Acute lymphoblastic leukemia; Philadelphia chromosome
• ISSN: 0953-7104; 1369-1635
• DOI: 10.3109/09537104.2014.935316

Abstract Dasatinib, which is an inhibitor of BCR-ABL and SRC family tyrosine kinases, is used for the treatment of patients with Philadelphia chromosome (Ph) positive leukemia, especially for those who develop resistance or who are intolerant to imatinib. The most common adverse effects attributed to its use are: myelosuppression, nausea, diarrhea, and peripheral edema. Hemorrhage, which could be gastrointestinal, genitourinary or central nervous system, is a less frequent adverse effect. In this case, we report a patient affected by precursor B-cell acute lymphoblastic leukemia (ALL) positive for the Ph chromosome translocation treated with the tyrosine kinase inhibitor (TKI) dasatinib. During the treatment with dasatinib the patient developed subdural hematoma (SDH). She did not have any head trauma, thrombocytopenia, coagulopathy or meningeal involvement, making dasatinib-induced platelet dysfunction the most likely cause of SDH.