Dasatinib-Induced Colitis in a Patient with Chronic Myelogenous Leukemia

diarrhea and hematochezia. The patient had a history of chronic myelogenous leukemia (CML), depression, high blood pressure, and obstructive sleep apnea. He was receiving dasatinib for the CML for two and a half years, following a previous imatinib therapy that failed due to drug resistance. Hematological remission had been achieved with dasatinib 2 months prior to the gastroenterological consultation. A control colonoscopy was performed and showed colonic loss of the normal submucosal vascular pattern with multiple areas characterized by edema, erythematous and papular lesions associated with erosions, small ulcers, and exudation (Fig. 1). This pattern was diffuse throughout the colon but more severe in the descending and sigmoid segments and rectum. The histopathological examination allowed the identification of mild irregular and branched crypts, diffuse lamina propria hemorrhage, and presence of eosinophils, neutrophils, and some eosinophilic crypt abscesses (Fig. 2). Apoptotic bodies and intraepithelial lymphocytes were absent. Cytomegalovirus infection was excluded with sample immunochemistry staining and Clostridium difficile infection was also excluded due to absence of the pathogenic toxin in a stool analysis. These endoscopic and pathological features are consistent with the diagnosis of dasatinib-induced colitis (DIC) [1, 2].