Dasatinib (Sprycel) is a second-generation tyrosine kinase inhibitor that plays a crucial role in the treatment of Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL).

What Are the Side Effects of Dasatinib (Sprycel)?

Common Side Effects

Hematological toxicity: Myelosuppression (neutropenia, thrombocytopenia, anemia).

Fluid retention events: Pleural effusion, peripheral edema, pulmonary edema.

Gastrointestinal reactions: Diarrhea (22%), nausea (10%).

Neurological symptoms: Headache (14%).

Skin reactions: Rash (14%).

Other common reactions: Bleeding events, dyspnea, fatigue, musculoskeletal pain.

Severe Adverse Reactions Requiring High Alert for Dasatinib (Sprycel)

Myelosuppression Crisis

Severe (Grade 3/4) thrombocytopenia, neutropenia, and anemia may occur.

Monitoring requirements: For adults with chronic-phase CML, complete blood count (CBC) should be tested every 2 weeks in the first 12 weeks, and then every 3 months thereafter. Patients with advanced-phase CML or Ph+ ALL need weekly testing until 2 months.

Increased Bleeding Risk

Dasatinib may cause severe or even life-threatening bleeding events.

In clinical studies, the incidence of Grade ≥3 central nervous system (CNS) bleeding was <1%, but bleeding at any site requires immediate medical intervention.

Pulmonary Arterial Hypertension (PAH)

It may occur at any time after the start of treatment (including more than 1 year later).

Typical symptoms: Dyspnea, fatigue, hypoxia, fluid retention.

Management principle: Permanent discontinuation of the drug is required once diagnosed.

Precautions for Using Dasatinib (Sprycel)

Administration Specifications

Swallow the tablets whole; do not crush, split, or chew them.

It can be taken with food or on an empty stomach.

Administer the drug at a fixed time every day.

Management of Drug Interactions

Strong CYP3A4 inhibitors (e.g., ketoconazole): Dose reduction should be considered.

Strong CYP3A4 inducers (e.g., rifampicin): Dose increase may be required.

Gastric acid regulators: Avoid concurrent use with H2-receptor antagonists or proton pump inhibitors.

Treatment Monitoring Specifications

Hematological monitoring: Regularly test the complete blood count.

Biochemical indicator monitoring: Test liver function monthly.

Cardiac monitoring: Regularly evaluate the electrocardiogram (ECG) and cardiac function.