Successful Desensitization to Oral Dasatinib in Immediate Hypersensitivity Reaction

A case report is presented, discussing the successful desensitization to dasatinib in a patient with chronic myeloid leukemia (CML) who experienced an immediate hypersensitivity reaction to the drug. The patient had previously been treated with imatinib but developed imatinib-induced pseudoporphyria, leading to discontinuation of treatment. The patient then started dasatinib but experienced a non-pruritic maculopapular exanthema and severe headache after the second dose. The patient was referred to the allergy unit, where a skin prick test and basophil activation test were performed. The skin prick test with dasatinib was negative, but the basophil activation test was positive. Considering the need to continue CML treatment and the patient's intolerance to other tyrosine kinase inhibitors (TKIs), a rapid dasatinib desensitization protocol was initiated, which was successful. The patient continues to tolerate dasatinib and the basophil activation test result has become negative. This case highlights the importance of desensitization in managing hypersensitivity reactions to TKIs and the potential for successful desensitization to dasatinib in patients with immediate hypersensitivity reactions.