{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:43:51Z","timestamp":1793371431196,"version":"4.5.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019014","name":"Chengdu Municipal Science and Technology Program","doi-asserted-by":"publisher","award":["No. 2024-YF05-00831-SN"],"award-info":[{"award-number":["No. 2024-YF05-00831-SN"]}],"id":[{"id":"10.13039\/501100019014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    Dasatinib is a second-generation tyrosine kinase inhibitor (TKI) used in Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), and chylothorax is one of its rare but serious lymphatic complications. We encountered a 14-year-old boy with Ph + acute lymphoblastic leukemia (ALL) who developed bilateral chylothorax while on dasatinib, with concurrent\n                    <jats:italic>B. henselae<\/jats:italic>\n                    infection (cat-scratch disease) confirmed in the pleural fluid. Prompted by this index case, we performed a systematic review of the literature to explore the potential association between dasatinib-associated chylothorax and\n                    <jats:italic>Bartonella henselae<\/jats:italic>\n                    infection. We searched multiple databases up to March 2026 and identified 24 cases of TKI-associated chylothorax and 11 cases of leukemia-related cat-scratch disease. In our index case, the pleural fluid triglyceride concentration reached 20.40\u00a0mmol\/L (\u22481806\u00a0mg\/dL)\u2014the highest value reported to date\u2014and mNGS detected\n                    <jats:italic>B. henselae<\/jats:italic>\n                    together with other organisms. After dasatinib was discontinued and the patient received chest drainage, somatostatin, fasting, and anti-infective therapy with doxycycline plus rifampicin, imaging showed near-complete resolution of the effusion, and repeat mNGS confirmed clearance of\n                    <jats:italic>B. henselae<\/jats:italic>\n                    . A formal causality assessment using the Naranjo scale gave a score of 7, indicating a \u201cprobable\u201d adverse drug reaction. This case illustrates that lymphatic and infectious complications can coincide in the same patient. Dasatinib-mediated inhibition of Src family kinases may simultaneously impair lymphatic endothelial integrity and suppress T-cell-mediated immune surveillance, thereby facilitating both chylous leakage and opportunistic infection. Clinicians managing paediatric patients receiving long-term dasatinib therapy should remain vigilant for both lymphatic complications and atypical opportunistic infections.\n                  <\/jats:p>","DOI":"10.3389\/fphar.2026.1897328","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:50Z","timestamp":1790574290000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Dasatinib-associated chylothorax and occult Bartonella henselae infection in pediatric leukemia: a case report and systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Caili","family":"Liu","sequence":"first","affiliation":[{"name":"Dujiangyan People\u2019s Hospital","place":["Dujiangyan City, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziting","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology 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