# Dasatinib-Associated Recurrent Symptomatic Bilateral Pleural Effusions in an Elderly Patient With End-Stage Renal Disease on Maintenance Hemodialysis

## TL;DR

An elderly patient with kidney disease on dialysis developed recurring lung fluid buildup possibly linked to long-term use of a cancer drug.

## Contribution

Highlights a rare but significant side effect of dasatinib in patients with end-stage renal disease.

## Key findings

- An 87-year-old patient on hemodialysis developed recurrent pleural effusions after seven years of dasatinib use.
- The cause of the effusions remains unclear, with possible links to dasatinib, kidney disease, or pulmonary hypertension.
- The case underscores the need for monitoring long-term drug effects in patients with complex medical conditions.

## Abstract

Dasatinib, a second-generation tyrosine kinase inhibitor, is effective in treating chronic myeloid leukemia but can occasionally cause pleural effusions, even after long-term therapy. We present the case of an 87-year-old male with end-stage renal disease (ESRD) on thrice-weekly maintenance hemodialysis who, over eight months in 2025, required repeated bilateral therapeutic thoracenteses for recurrent symptomatic pleural effusions. These effusions developed more than seven years after initiating dasatinib, raising the question of whether they were secondary to dasatinib, ESRD-associated hypervolemia, or newly diagnosed pulmonary hypertension.