Or pleurodesis indicated; grade 4, life-threatening (e.g., causing hemodynamic instability); grade 5, death. Data from

Or pleurodesis indicated; grade 4, life-threatening (e.g., causing hemodynamic instability); grade 5, death. Data from Shah et al[22]Page 3 of(page number not for citation purposes)Journal of Hematology Oncology 2009, 2:http://www.jhoonline.org/content/2/1/Evidence of Pleural Effusion (cough, dyspnea, chest pain, etc.)Perform chest x-ray to confirm diagnosisaDetermine severity of confirmed eventInterrupt therapy until adverse event improves to grade PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27741243 on treatment with dasatinib. aBMS, 2009 [13]. bNCCN, 2009 [2]. Abbreviation: ANC = absolute neutrophil count pleural effusion, therapy should be interrupted until the event improves and later resumed at a reduced dose. The use of diuretics and steroids may be warranted. If an immune-related mechanism is indeed responsible for pleural effusion occurring during dasatinib treatment, corticosteroids are likely to be more effective than diuretics as an adjunct to dose reduction/interruption [26,29]. Cross-intolerance between nilotinib and Pleconaril side effects Imatinib was minimal in these studies. While imatinib has been commonly associated with grade 1-2 fluid retention (59.9 in the multicenter phase III study that led to its approval), nilotinib is not as frequently associated with these events. Any-grade peripheral edema was reported in 11 of patients with CP CML receiving nilotinib, but none of these cases were severe [14]. Patients with AP CML experienced similar rates of edema. Pleural effusions is uncommonly associated with nilotinib therapy (1 ) [30]. Management of these AEs is best treated with dose interruptions, and therapy can be resumed at the 400 mg once daily dose after resolution [14]. Besides fluid retention, other adverse events contribute to the safety profile of both imatinib and nilotinib, and HCPs should be familiar with these before initiating therapy.NilotinibNilotinib, a derivative of imatinib, was approved by the FDA in late 2007 for the treatment of adult patients with CP or AP CML resistant or intolerant to prior therapy with imatinib. The activity of nilotinib (400 mg orally twice daily) in patients with all phases of CML resistant or intolerant to imatinib has been confirmed in phase II studies [30-32]. In a trial of 280 patients with CP CML, a MCyR rate of 48 was observed after 6 months of follow-up [31]. At 12 months, the estimated survival was 95 .Page 4 of(page number not for citation purposes)Journal of Hematology Oncology 2009, 2:http://www.jhoonline.org/content/2/1/ConclusionCurrently three TKI therapies are available to patients with CML. Imatinib remains the recommended frontline therapy for patients with CP CML, but two new therapies, dasatinib and nilotinib, are available for CML patients who are resistant to or intolerant of imatinib therapy. Although the newer TKIs are similar, there are differences in their side-effects and indications. To date, there is no data comparing the efficacy of these three drugs directly, but these studies are currently ongoing. This article has focused specifically on the management of pleural effusions associated with dasatinib therapy. Fluid retent.