Adverse reactions of dasatinib in pediatric acute lymphoblastic leukemia: a retrospective comparative cohort study.

Background: Dasatinib is increasingly used in the treatment of pediatric acute lymphoblastic leukemia (ALL) for its potent efficacy. However, the specific spectrum and incidence of adverse reactions attributable to it remain incompletely defined in the pediatric population. This retrospective cohort study aims to clarify the safety profile of dasatinib by directly comparing the incidence and types of adverse reactions between pediatric ALL patients who received dasatinib and those who did not. Methods: This retrospective cohort study enrolled children with ALL treated at Shanghai Children's Medical Center between May and September 2024. Patients were allocated into the dasatinib group (n=144) if they received oral dasatinib (80 mg/m Results: The two groups were comparable in terms of age and sex distribution (P>0.05), though the dasatinib group, by nature of its indication, contained a higher proportion of high-risk patients (e.g., BCR-ABL1 Conclusions: Dasatinib is associated with a significantly increased risk of hematologic and specific cardiovascular adverse reactions in pediatric ALL patients. These findings underscore the necessity for vigilant, protocol-driven monitoring of blood counts and cardiac function (including echocardiography) during dasatinib therapy. Proactive management strategies should be considered to mitigate these risks and improve treatment safety.