Diazoxide-Responsive Hypoglycemia in a Child Receiving Dasatinib for Treatment of B-Cell Acute Lymphoblastic Leukemia

Tyrosine kinase inhibitors (TKIs) are being used more regularly in treatment regimens for pediatric cancers. They have distinct side effect profiles, including endocrinopathies. Here we present a 2-year-old boy with Philadelphia chromosome-like (Ph-like) B-cell acute lymphoblastic leukemia (ALL) who developed refractory hypoglycemia after using dasatinib. His evaluation was suggestive of hyperinsulinism, and his symptoms were ultimately controlled with diazoxide. There have not been any published data exploring the relationship between TKIs and glycemic profiles in pediatric patients. In adults, there is research indicating that patients using TKIs could experience both hyperglycemia and hypoglycemia. The pathophysiology of these side effects is not well described, nor are the risk factors for development. More research is needed to understand these relationships in general, but particularly in the pediatric population.