Sprycel

Sprycel is the brand name for dasatinib, an oral tyrosine kinase inhibitor used to treat certain leukemias. It targets BCR-ABL1, the abnormal fusion protein produced by the Philadelphia chromosome, and also inhibits other kinases such as SRC family kinases, c-KIT, and PDGFR beta. By blocking these signaling pathways, dasatinib reduces malignant cell proliferation and can promote cancer cell death.

Sprycel is approved for chronic myeloid leukemia (CML) in chronic phase, accelerated phase, and blast phase, and for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). It is used in patients who are resistant or intolerant to imatinib and, in some cases, as initial therapy based on physician judgment. Dosing varies by indication and patient factors; commonly 100 mg once daily for chronic phase CML and 140 mg once daily for advanced CML or ALL, with adjustments for tolerability and safety.

Sprycel is taken orally, with or without food. It is extensively metabolized in the liver, mainly by the CYP3A4 enzyme, and its levels can be affected by strong CYP3A4 inhibitors or inducers as well as certain anticoagulants or antiplatelet drugs. Caution is advised regarding potential QT interval prolongation and increased bleeding risk due to cytopenias.

Common side effects include decreases in blood cell counts (anemia, neutropenia, thrombocytopenia), fluid retention with edema or pleural effusion, diarrhea, rash, and fatigue. Serious toxicities can include pleural or pericardial effusions, pulmonary hypertension, liver injury, and severe bleeding. Patients on Sprycel require regular monitoring of blood counts, liver enzymes, and signs of fluid retention or cardiac or pulmonary symptoms.