Summary

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• Dasatinib (Sprycel) is indicated for the treatment of various phases of Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) and acute lymphoblastic leukemia (Ph+ ALL), including newly diagnosed adults, pediatric patients 1 year of age and older, as well as those with resistance or intolerance to prior therapy.
• The information was derived from a total of 7 systematic reviews/meta-analyses. These studies compared dasatinib's safety and effectiveness with other tyrosine kinase inhibitors such as imatinib, nilotinib, and bosutinib across different patient populations.
• In terms of hematological adverse events like anemia, neutropenia, and thrombocytopenia, dasatinib showed a higher prevalence than its counterparts. However, in pediatric Ph+ ALL patients, it demonstrated superior overall survival rates when compared to imatinib.
• Despite being associated with severe hematological toxicities making it less safe than other TKIs like nilotinib, dasatinib did not show increased hepatotoxic risks, unlike others such as nilotinib, bosutinib, and ponatinib, which were linked to higher relative risks of hepatotoxicity.
• When used after allogeneic hematopoietic stem cell transplantation in Ph+ ALL patients, dasatinib showed beneficial outcomes by maintaining disease-free survival rates. This indicates that despite having more side effects, it offers considerable advantages, especially for specific subgroups like pediatric patients suffering from Ph+ ALL.
• Due consideration should be given to the elevated risk for adverse effects, particularly where comorbidities or specific patient populations are considered.