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Pleural Effusion

Hello Everybody,

After being treated for a long lasting chest infection and hayfever for the past 2 months and having my suggestion of pleural effusion as a side effect of Dasatinib dismissed, my gp ordered a chest xray for saturday morning (yesterday)... upon reading this xray, the radiologist also did a ct scan, then told me in no uncertain terms to go to the medical centre and wait for my gp to arrive and reassess my niggly cough and breathlessness.

The scan showed a large pleural effusion covering my entire right lung and a partial collapse - apart from what the images reveal, i am completely asymptomatic.

I spent the rest of the day and most of last night at St Vincents Hospital in Sydney, being monitored, poked and prodded by many doctors who were trying to decide on the best course of action until my haemotolgist could be consulted. Initially, it was all systems go for a chest drain, until at the 11th hour my haemo was located. He prescribed a diuretic and i was able to leave the hospital with directions to immediately stop taking dasatinib and all of the superfluous antibiotics. I will hopefully be squeezed into my haemos consults on tuesday.

I'm guessing I'll be prescribed a different TKI... does anyone have any suggestions as to which TKI i should request if given the opportunity. Also, what questions should i be asking re. treatment and the possibility of P.E recurrence.

I've been taking Dasatinib 100mg daily for the past 18 months since diagnosis and my last bcr-abl result came back 0.085%(IS) log red 3.07 (up from 0.047% 3 months earlier). My next big quarterly blood test is scheduled for mid september.

Have a fabulous day, Lynette Black

Hi Lynette,

First bit of advice is that if you feel something is not quite right then cut out the GP and go straight to your haematologist.  That said, at least now you have a clear diagnosis of PE which is a known side effect of dasatinib. However, experience with this drug has shown that it is reversible and clinical research has shown it can be managed so you can stay on dasatinib. The manufacturers have good visual legend that your clinician is probably aware of but here is a link to that .... you will see that as this is your first episode of PE, they advise that you stop until it resolves then re-introduce therapy but at a lower dose. If PE recurs you should then think about changing therapy.

http://www.bms.se/filer/Sprycelpleuravatska_67183.pdf

Hope this helps,

Sandy

Hi Sandy, thank you so much for your prompt reply. The flyer you have attached and your understanding of PE are incredibly useful. Thank you once again and thank you for this amazing forum. Have a wonderful night, Lynette Black