skip to main content

Dasatinib Pleural Effusions/PAH — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHaematologyDasatinib Pleural Effusions/PAHRACP Adult Medicine

A 45-year-old man with chronic myeloid leukaemia on dasatinib develops progressive exertional dyspnoea. CXR shows bilateral pleural effusions. Echocardiography shows no pericardial effusion and normal LV function. Estimated PASP is 55 mmHg (elevated). What is the most likely drug-related complication?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Dasatinib-induced pleural effusions and pulmonary arterial hypertension

Dasatinib uniquely causes pleural effusions (in 15–35% of patients) and pulmonary arterial hypertension (in 0.5–5%), which are not typically seen with other TKIs (imatinib, nilotinib, bosutinib). The pleural effusions are lymphocyte-rich and respond to dose interruption/reduction and short-course corticosteroids. Dasatinib-associated PAH may be reversible if detected early and the drug is switched. If significant pleural effusions or PAH develop, dasatinib should be switched to an alternative TKI (nilotinib, bosutinib). Regular monitoring for these complications is recommended.

Reference: AMH – 2025 – Dasatinib; eTG – 2025 – Haematology