may be an effective chemotherapy regimen for elderly AML patients with an expected better safety profile than that of the regimen used in our study. The ongoing UK AML 16 Trial, which evaluates a regimen combining low-dose cytarabine (20 mg/12 h, days 1–10) and low dose GO (5 mg, day 1) in patients not considered fit for intensive treatment, will better define the clinical benefit resulting from such a strategy (http:// www.download.bham.ac.uk/bctu/AML16/Trial/AML16%20 Protocol%20V5%20May%202006.pdf). Je ´ro ˆme Doyen 1 Antoine Italiano 1 Fre ´de ´ric Peyrade 1 Claude Bouyer 2 Antoine Thyss 1 Departments of 1 Medical Oncology, and 2 Medical Biology, Centre Antoine-Lacassagne, Canceropo ˆle PACA, Nice, France. E-mail: italiano@unice.fr References McKoy, J.M., Angelotta, C., Bennett, C.L., Tallman, M.S., Wadleigh, M., Evens, A.M., Kuzel, T.M., Trifilio, S.M., Raisch, D.W., Kell, J., DeAngelo, D.J. & Giles, F.J. (2007) Gemtuzumab ozogamicin- associated sinusoidal obstructive syndrome (SOS): an overview from the research on adverse drug events and reports (RADAR) project. Leukemia Research, 31, 599–604. Morris, K.L., Adams, J.A. & Liu Yin, J.A. (2006) Effect of gemtuzumab ozogamicin on acute myeloid leukaemia blast cells in vitro, as a single agent and combined with other cytotoxic agents. British Journal Haematology, 135, 509–512. Pagano, L., Fianchi, L., Caira, M., Rutella, S. & Leone, G. (2007) The role of gemtuzumab ozogamicin in the treatment of acute myeloid leukemia patients. Oncogene, 26, 3679–3690. Piccaluga, P.P., Martinelli, G., Rondoni, M., Malagola, M., Gaitani, S., Visani, G. & Baccarani, M. (2004) First experience with gemtuzumab ozogamicin plus cytarabine as continuous infusion for elderly acute myeloid leukaemia patients. Leukemia Research, 28, 987–990. Stasi, R., Evangelista, M.L., Buccisano, F., Venditti, A. & Amadori, S. (2008) Gemtuzumab ozogamicin in the treatment of acute myeloid leukemia. Cancer Treatment Reviews, 34, 49–60. Keywords: acute myeloid leukaemia, gemtuzumab ozogami- cin, elderly, cytarabine, refractory leukaemia. First published online 28 March 2008 doi:10.1111/j.1365-2141.2008.07096.x Pleural effusions in patients with chronic myeloid leukaemia treated with dasatinib may have an immune-mediated pathogenesis The development of pleural effusions is a frequent complica- tion of dasatinib therapy (Cortes et al, 2007; Guilhot et al, 2007; Hochhaus et al, 2007); it has been reported in 14–35% of chronic myeloid leukaemia (CML) patients on dasatinib, and this may necessitate interruptions and/or reductions in the dose of dasatinib (Cortes et al, 2007; Guilhot et al, 2007; Hochhaus et al, 2007). Several risk factors for the development of pleural effusions have been identified, but the aetiology of the effusion remains unclear. We retrospectively analysed our series of 62 consecutive CML patients treated with dasatinib at Hammersmith Hospital to identify factors predictive for the development of pleural effusions. Chest X-rays were performed in all patients with respiratory symptoms. Clinical management included tempo- rary or permanent discontinuation of the dasatinib, dose modification, administration of steroids and/or diuretics and thoracocentesis. The probability of pleural effusion was calculated using the cumulative incidence procedure. Univar- iate analysis to identify prognostic factors (Table I) for the development of pleural effusion was carried out using the log- rank test. Variables found to be significant at the P <0Æ25 level were entered into a proportional hazards regression analysis. The influence of the development of skin rash during dasatinib therapy on the development of pleural effusion was studied using a time dependent Cox model. P-values were two-sided, with values <0Æ05 considered significant, and confidence intervals (CI) refer to 95% boundaries. Median age was 58Æ2 years (range, 29–79 years). Among them 46 (74%) were in chronic phase (CP), seven (11%) in accelerated phase and nine (15%) in blastic phase. Forty-six patients started dasatinib at a dose of 70 mg twice daily, nine at 50 mg twice daily, three at 140 mg once daily and four at 100 mg once daily. Seventeen patients (27%) developed respiratory symptoms and pleural effusions at a median of 179 d from the initiation of dasatinib therapy (range, 20– 756 d). The cumulative incidence of pleural effusion at 1 year was 29Æ5% (95% CI 18Æ6–43Æ3%). Among the patients who developed effusions, 14 were of grade 2 and 3 were of grade 3 severity. Fifteen were unilateral, and two bilateral; two had concomitant grade 2 pericardial effusions on echocardiography without any sign of pulmonary hypertension. As described by others (Bergeron et al, 2007), additional lung abnormalities Correspondence ª 2008 The Authors Journal Compilation ª 2008 Blackwell Publishing Ltd, British Journal of Haematology, 141, 734–747 745