Dasatinib-Triggered Severe Hypocalcemia in a Patient with Chronic Kidney Disease and Osteoporosis

Cureus. 2023 Nov 9;15(11):e48555. doi: 10.7759/cureus.48555. eCollection 2023 Nov.

Abstract

Given the increasing prevalence of chronic myeloid leukemia (CML) in older individuals, careful selection of tyrosine kinase inhibitors (TKIs) is required. The case of an 84-year-old woman with chronic-phase CML and chronic kidney disease undergoing osteoporosis, in whom dasatinib triggered severe hypocalcemia, is reported. She was intolerant to both imatinib and nilotinib. Initiation of low-dose dasatinib treatment led to severe hypocalcemia and long QT syndrome, compounded by vitamin D deficiency and denosumab use. We stopped dasatinib, and her hypocalcemia was improved after calcium administration. This case highlights the potential of TKIs in triggering hypocalcemia, emphasizing the need to assess mineral disorders before initiating TKI therapy.

Keywords: chronic kidney disease; chronic myeloid leukemia; dasatinib; hypocalcemia; long qt syndrome; osteoporosis.

Publication types

  • Case Reports