Colitis hemorrágica asociada a dasatinib en LLA Ph+: presentación de un caso

The Philadelphia chromosome (Ph) is the cytogenetic anomaly most commonly found in patients with acute lymphoblastic leukemia (ALL). The result of this mutation is the BCR-ABL protein, an active kinase involved in cell signaling and survival. Dasatinib is a second-line tyrosine kinase inhibitor used in patients with imatinib resistance or intolerance with chronic myeloid leukemia (CML) and ALL Ph+. Side effects of this drug include myelosuppression, pleural effusion, diarrhea, and liver enzyme abnormalities.Gastrointestinal bleeding may occur with the use of dasatinib, but is generally mild and easily handled. Nevertheless, there are a few case reports of severe acute colitis related to dasatinib. We present the case of a 55-year-old male with diagnosis of ALL Ph+ that presented hemorrhagic colitis after 3 months of treatment with dasatinib. Clostridium difficile, citomegalovirus and other enteric pathogens infections were discarded. Video colonoscopy evidenced pancolitis and the pathological anatomy revealed acute exacerbation of chronic colitis. With other causes discarded, dasatinib treatment was stopped with clinical improvement within 72 hours.