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Case Reports: Adverse drug reactions and complications
Dasatinib-associated follicular lymphoma in a patient with B-cell acute lymphoblastic leukaemia
  1. Katherine Ismei Zhou1,
  2. Chenyu Lin2,
  3. Jadee Lee Neff3 and
  4. Ahmed Galal2
  1. 1Division of Medical Oncology, Duke University Health System, Durham, North Carolina, USA
  2. 2Division of Hematologic Malignancies & Cellular Therapy, Duke University Health System, Durham, North Carolina, USA
  3. 3Department of Pathology, Duke University Health System, Durham, North Carolina, USA
  1. Correspondence to Dr Ahmed Galal; ahmed.galal{at}duke.edu; Dr Jadee Lee Neff; jadee.neff{at}duke.edu

Abstract

The tyrosine kinase inhibitor dasatinib is approved for the treatment of chronic myeloid leukaemia and Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL). Patients on dasatinib can rarely develop a form of benign reversible reactive lymphadenopathy termed follicular lymphoid hyperplasia (FLH). Here, we describe a patient with Ph+ ALL who developed follicular lymphoma (FL) after prolonged treatment with dasatinib and who had complete remission of FL after discontinuation of dasatinib. This case suggests that dasatinib-associated FLH could be a premalignant condition that can transform into FL. Moreover, withdrawal of dasatinib may be sufficient for remission of dasatinib-associated FL.

  • Dasatinib
  • Haematology (incl blood transfusion)
  • Oncology
  • Tyrosine Kinase Inhibitor

https://doi.org/10.1136/bcr-2022-252739

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    Footnotes

    • JLN and AG are joint senior authors.

    • JLN and AG contributed equally.

    • Contributors AG and JN had equal contributions to this work and conceived the work. JN interpreted the pathology results. KZ wrote the initial draft of the paper. CL, JN and AG made revisions to the paper. KZ, CL and JN made the figures. The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KZ, CL, JN and AG. The following authors gave the final approval of the manuscript: KZ, CL, JN and AG.

    • Funding Author CL was supported by the National Heart, Lung, and Blood Institute T32 training grant (HL007057-46).

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.