A fecal occult blood test (FOBT) followed by a colonoscopy may be effective in detecting hemorrhagic colitis among patients with chronic myeloid leukemia (CML) treated with dasatinib, according to a study published in Blood.1

In a prospective study, researchers evaluated 30 patients with CML who were treated with a tyrosine kinase inhibitor (TKI) and had undergone FOBTs. The goal was to examine the efficacy of this treatment as a method of screening and determine the frequency of TKI-induced hemorrhagic colitis.

The researchers performed colonoscopy on patients who had a positive FOBT. Treatment with TKI was interrupted and FOBTs were reassessed when patients were pathologically identified as having TKI-induced hemorrhagic colitis.

The first FOBT was positive among 10 out of 30 patients observed. Patients who had positive FOBTs underwent treatment with dasatinib and developed no symptoms of hemorrhagic colitis.

The investigators were also able to confirm dasatinib-induced hemorrhagic colitis in 6 out of 18 patients. Upon use of endoscopy, it was found that dasatinib-induced hemorrhagic colitis was characterized by a red flare or erosion. Immunohistological analyses demonstrated CD3+, CD8+, CD56+, and Granzyme B+ cytotoxic T lymphocyte infiltration.

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These findings suggest that dasatinib-induced hemorrhagic colitis may be asymptomatic, and fecal occult blood test followed by a colonoscopy may effectively detect occurrence in patients with CML.

Reference

  1. Nishiwaki S, Maeda M, Yamada M, et al. Clinical efficacy of fecal occult blood test and colonoscopy for dasatinib-induced hemorrhagic colitis in CML patients. Blood. 2016 Nov 8. doi:10.1182/blood-2016-08-734947 [Epub ahead of print]