Dasatinib is drug that can be used to treat chronic myeloid leukemia (CML). It can also be used to treat some adults with acute lymphoblastic leukemia (ALL).

WHAT IS DASATINIB?

Dasatinib is a type of treatment called a tyrosine kinase inhibitor. Kinases are proteins that regulate the way cells grow and divide.

HOW DOES DASATINIB WORK?

Dasatinib acts by blocking signals within the leukemia cells that make them grow and divide. Blocking the signals causes them to die.

WHEN IS DASATINIB USED?

Dasatinib is given as a treatment for people with:

• chronic myeloid leukemia who are Philadelphia chromosome posive (LMC Ph +) who have already had other treatments, including imatinib.
• acute lymphoblastic leukemia who are Philadelphia chromosome positive and who do not respond to other treatments, or for whom the side effects of these treatments are too severe.

WHAT DOES DASATINIB LOOK LIKE?

Dasatinib is a whitish tablet. It is given in four different dose sizes: 20 mg, 50 mg, 70 mg, and 100 mg. Depending on the dose size given, the tablets can be round, oval-shaped, or triangular.

HOW IS DASATINIB TAKEN?

Dasatinib should be taken with a large glass of water, either with or without food. It is normally taken once a day, and should be taken at around the same time every day. You should not crush or break up the tablets.

POSSIBLE SIDE EFFECTS OF DASATINIB

Each person reacts differently to dasatinib. Some people have very few side effects, while others may develop more. The side effects described here will not affect everyone who is treated with the drug.

We outline the most commonly side effects, though we have left out the rarer ones. If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.

The side effects of dasatinib are normally mild or moderate and usually go away after the treatment is finished. However, some more serious problems can occur sometimes. Side effects happen mostly during the first two months of treatment and may begin to go away little by little after the treatment is over.

However, some people can develop late effects. Tell your doctor if your side effects persist or are bothersome.

RISK OF INFECTION

Dasatinib can reduce your number of white blood cells, which help fight off infection. White blood cells are produced by bone marrow. If your white blood cell count is low, you will be more prone to infection. A low number of white blood cells is called neutropenia.

Contact your doctor or your hospital immediately if:

• your temperature rises above 38 ° C
• you suddenly feel unwell, even if your temperature is normal.

If your blood count is too low, your doctor may ask you to stop taking dasatinib or lower the dose for a period of time.

BRUISING AND BLEEDING

Dasatinib can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising, such as nosebleeds, bleeding gums, blood spots, or skin rashes. You may have a platelet transfusion if your platelet count is low. Your doctor may ask you to stop taking dasatinib or lower the dose for a period of time.

ANEMIA (LOW RED BLOOD CELLS)

Dasatinib can reduce the number of red blood cells, which transport oxygen throughout the body. A low number of red blood cells is called anemia. This may make you feel tired and short of breath. Tell your doctor or nurse if you have these symptoms. You may need a blood transfusion if the number of red blood cells in your blood is too low.

BUILD-UP OF FLUID

This can affect different parts of the body. The most common effect is swelling of the ankles or the area around the eyes. There is often no way of treating fluid build-up; however, it can be treated, and there are certain drugs that help you produce more urine (diuretics).

A short course of steroids may also be of help. Sometimes, fluid can build up in the lining of the lungs (pleural effusion). Rarely, it can accumulate in the abdomen (ascites) or in the sac around the lungs (pericardial effusion).

Let your doctor know immediately if you develop a cough or chest pain or if you have sudden weight gain.

DIARRHEA

Dasatinib can cause diarrhea. Normally, this can be easily controlled with drugs, though you should tell your doctor if your diarrhea is severe or ongoing. It's important to drink lots of fluids if you have diarrhea.

NAUSEA AND VOMITING

Your doctor can prescribe antiemetic drugs, which can prevent or substantially reduce your nausea and vomiting.

If your nausea remains uncontrolled or continues, tell your doctor, as they can prescribe other drugs that could work better. Some antiemetic drugs can cause constipation. Tell your doctor or nurse if this is a problem.

HEADACHES

Tell your doctor if you have headaches, as he or she can advise you on what could help you.

MUSCLE AND BONE PAIN

Some people have pain in their muscles, joints, and bones while they are having the treatment. If this is your case, your doctor can prescribe painkillers to help.

SKIN CHANGES

Rashes, dryness, itchiness, increased perspiration, or greater sensitivity to sunlight are common effects. These side effects are normally minor. Tell your doctor or nurse immediately if you notice any of these changes in your skin. They can recommend creams or lotions you can use; also, they can prescribe drugs to relieve the itchiness.

TIREDNESS (FATIGUE)

This is common, though it is often mild. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks.

ABDOMINAL PAIN

Some people have abdominal pain or discomfort when they take dasatinib.

EFFECTS ON THE EYES

Your eyes may become dry and your vision may turn blurry. In some people, this may affect their ability to drive safely. Talk to your doctor if you notice any of these changes.

LOSS OF APPETITE

Some people lose their appetite while taking dasatinib. This can be mild and last for a few days. If it doesn't get better, request to see a dietitian or specialist nurse at your hospital. They can give you advice on how to improve your appetite and maintain a healthy weight.

DIZZINESS

Some people become dizzy at times. Tell your doctor if this happens to you. Dasatinib may affect your ability to drive.

CHANGES TO SENSATIONS IN THE HANDS AND FEET

Dasatinib can sometimes cause tingling or numbness of the hands or feet. This can make tasks such as fastening small buttons more difficult. Tell your doctor if this affects you.

SORENESS OF THE MOUTH AND MOUTH ULCERS

You may notice that you develop mouth pain or small ulcers. Drinking lots of fluids and regularly brushing your teeth gently using a soft-bristled toothbrush can help lower the risk of this happening. Tell your doctor or nurse if you have any of these problems, as they can prescribe a mouthwash and drugs to prevent infection in the mouth.

CONSTIPATION

In general, it may help to drink lots of fluids, eat more fiber, and get some light exercise. You may have to take medication (laxatives) to help with this. Your doctor can prescribe these or you can buy them at the pharmacy.

CHANGES TO THE HEART RATE

A small percentage of people may notice a change in their heart rate. Your heartbeat may become more irregular or quicken. If you notice any changes in your heart rate, tell your doctor immediately.

ADDITIONAL INFORMATION ON DASATINIB

OTHER MEDICINES

Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking dasatinib. Tell your doctor if you are taking any medicines, including over-the-counter drugs, complementary therapies, and herbal remedies.

CONTRACEPTION

It is not advisable to become pregnant while taking dasatinib, as the drug can harm developing babies. It is important to use an effective method of contraception while you take this drug and for at least a couple of months afterward. You can talk about this with your doctor.

It is unknown whether dasatinib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.

FERTILITY

This treatment may effect your ability to conceive or give birth. It is important that you talk to your doctor before beginning treatment.

BREASTFEEDING

There is a potential risk that dasatinib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.