An Analysis of Dasatinib Treatment Patterns in Patients with Chronic Myeloid Leukemia after Experiencing Pleural Effusion during Dasatinib Therapy

Acta Haematol. 2023;146(4):259-266. doi: 10.1159/000530512. Epub 2023 Apr 10.

Abstract

Introduction: Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion; however, data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion.

Methods: Adults with CML and ≥1 pharmacy claim for dasatinib in 2015-2018 who experienced pleural effusion after dasatinib were identified using data from claims databases.

Results: Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; among these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p < 0.001). HCRU and costs were similar between groups.

Conclusion: Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.

Keywords: Chronic myeloid leukemia; Hematological; Malignant hematology; malignancies.

MeSH terms

  • Adult
  • Costs and Cost Analysis
  • Dasatinib / adverse effects
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / complications
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Pleural Effusion* / chemically induced
  • Pleural Effusion* / diagnosis
  • Protein Kinase Inhibitors / adverse effects

Substances

  • Dasatinib
  • Protein Kinase Inhibitors