Dasatinib-Associated Gastrointestinal Bleeding and Colitis: A Narrative Review with Illustrative Cases
6 affiliations
- 1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169608, Singapore
- 2Duke-NUS Medical School, Singapore 169857, Singapore
- 3SingHealth Polyclinics—Outram Polyclinic, Singapore 168937, Singapore
- 4Department of Haematology, National Cancer Centre, Singapore 168583, Singapore
- 5Division of Pathology, Singapore General Hospital, Singapore 169608, Singapore
- 6Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore 168583, Singapore
Abstract
Dasatinib, an oral tyrosine kinase inhibitor used for chronic myeloid leukaemia (CML), is increasingly linked to gastrointestinal (GI) toxicities that remain under-recognised in clinical practice, ranging from mild, self-limiting symptoms to clinically significant GI bleeding and inflammatory colitis. This narrative review synthesises the published literature on dasatinib-associated GI bleeding and colitis, examining the mechanisms involved, including Src-family-kinase-mediated platelet dysfunction, endothelial barrier disruption and immune-driven T-cell infiltration, together with evidence on diagnosis and management. Dasatinib-associated colitis is far more extensively reported than non-colitis bleeding, has been reported across a broad adult age range and in both sexes, and has onset ranging from immediate to 9 years after initiation. Haematochezia, diarrhoea and abdominal pain are the most common presentations; endoscopic and histopathological findings are typically nonspecific and often mimic inflammatory bowel disease. The review is illustrated by two cases from a tertiary referral centre: delayed bleeding after cold-snare polypectomy of a diminutive 3 mm colorectal polyp, and chronic active colitis on combination asciminib–dasatinib therapy; formal causality assessment rated a dasatinib contribution as possible and probable, respectively. Dasatinib-associated GI complications, from delayed mucosal bleeding to chronic colitis, are clinically significant and warrant early recognition and multidisciplinary, individualised management. Standardised diagnostic criteria and peri-procedural guidance are needed to better balance bleeding risk against leukaemia control.
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BibTeX
@article{nhi2026dasatinibassociated,
title = {{Dasatinib-Associated Gastrointestinal Bleeding and Colitis: A Narrative Review with Illustrative Cases}},
author = {Nguyen Thi Mai Nhi and Shyn Yi Tan and Justin Wen Hao Leong and Valerie Shu Xian Yeap and Bochao Jiang and Aloysius Jiawei Loo and Jing Yuan Tan and Denise Tan Yan and Yeow Tee Goh and Kok Hing Lim and Yu Bin Tan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208086},
url = {https://www.mdpi.com/2077-0383/15/20/8086},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Dasatinib-Associated Gastrointestinal Bleeding and Colitis: A Narrative Review with Illustrative Cases
AU - Nguyen Thi Mai Nhi
AU - Shyn Yi Tan
AU - Justin Wen Hao Leong
AU - Valerie Shu Xian Yeap
AU - Bochao Jiang
AU - Aloysius Jiawei Loo
AU - Jing Yuan Tan
AU - Denise Tan Yan
AU - Yeow Tee Goh
AU - Kok Hing Lim
AU - Yu Bin Tan
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208086
UR - https://www.mdpi.com/2077-0383/15/20/8086
AB - Dasatinib, an oral tyrosine kinase inhibitor used for chronic myeloid leukaemia (CML), is increasingly linked to gastrointestinal (GI) toxicities that remain under-recognised in clinical practice, ranging from mild, self-limiting symptoms to clinically significant GI bleeding and inflammatory colitis. This narrative review synthesises the published literature on dasatinib-associated GI bleeding and colitis, examining the mechanisms involved, including Src-family-kinase-mediated platelet dysfunction, endothelial barrier disruption and immune-driven T-cell infiltration, together with evidence on diagnosis and management. Dasatinib-associated colitis is far more extensively reported than non-colitis bleeding, has been reported across a broad adult age range and in both sexes, and has onset ranging from immediate to 9 years after initiation. Haematochezia, diarrhoea and abdominal pain are the most common presentations; endoscopic and histopathological findings are typically nonspecific and often mimic inflammatory bowel disease. The review is illustrated by two cases from a tertiary referral centre: delayed bleeding after cold-snare polypectomy of a diminutive 3 mm colorectal polyp, and chronic active colitis on combination asciminib–dasatinib therapy; formal causality assessment rated a dasatinib contribution as possible and probable, respectively. Dasatinib-associated GI complications, from delayed mucosal bleeding to chronic colitis, are clinically significant and warrant early recognition and multidisciplinary, individualised management. Standardised diagnostic criteria and peri-procedural guidance are needed to better balance bleeding risk against leukaemia control.
SN - 2077-0383
ER -