Dasatinib induced perinephric hematoma in a patient with chronic myeloid leukemia: an uncommon adverse event of Dasatinib therapy

Abstract

Dasatinib, a second-generation tyrosine kinase inhibitor (TKI) used in chronic myelogenous leukemia and Ph-positive leukemias, is known for adverse effects such as myelosuppression, gastrointestinal disturbances, fluid retention, rashes, and bleeding diathesis. This report presents a rare case of Dasatinib-induced perinephric hematoma in a 60-year-old woman with BCR-ABL–positive CML. Shortly after initiating Dasatinib, she developed frank hematuria, and CT-KUB revealed a large right perinephric hematoma with active bleeding from right renal artery branches, requiring embolization. No alternative etiology for the hemorrhage was identified. Discontinuation of Dasatinib and supportive management—including blood transfusion and intravenous fluids—led to gradual hematoma resolution without recurrence. A Naranjo score of 7 indicated a probable drug-related adverse event. This case emphasizes the need for clinicians to recognize rare but serious bleeding complications of Dasatinib, which may occur despite normal platelet counts and normal coagulation parameters, likely due to impaired platelet function.