Beyond Conventional Therapy: Role of Pulse Steroids in Bleomycin Induced Lung Injury

Gupta, Raghav; Ettinger, Neil A.

doi:10.4187/respcare.02560

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…1 g/day IV) was for grade 3 pneumonitis [ 13 ]. However, the optimal dose and course of glucocorticoids remain unclear [ 19 ], and prospective studies integrated with a schedule for follow-up investigation of the subtype of IP could be helpful in addressing this. In our study, intravenous or oral glucocorticoids at an initial dose of 0.5–1.5 mg/kg/day were administered to most patients and were tapered gradually (reduced by 25% every week) in those patients who were responding.…”

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confidence: 99%

Incidence, clinical characteristics, and outcome of interstitial pneumonia in patients with lymphoma

et al. 2017

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Interstitial pneumonia (IP) is a lethal complication in lymphoma patients undergoing chemotherapy. A total of 2212 consecutive patients diagnosed with lymphoma between 2009 and 2014 were enrolled in the present study. IP was defined as diffuse pulmonary interstitial infiltrate found on computed tomography scans. IP was observed in 106 patients. Of these, 23 patients were excluded from the study. Finally, 83 patients with IP were included in this study. The incidence of IP was 3.9% (7/287) in Hodgkin lymphoma and 2.4% (76/1925) in non-Hodgkin lymphoma (P = 0.210). The median number of chemotherapy cycles before IP was 3. The median time from the cessation of chemotherapy to IP was 17 days. Eighty-two (98.8%) patients recovered after the treatment with glucocorticoids. Sixty-six (79.5%) patients had a delay in chemotherapy, and 14 (16.9%) patients had premature termination of chemotherapy. Sixty-nine patients were re-treated with chemotherapy after remission from IP, of which 22 (31.9%) experienced IP recurrence. The incidence of IP recurrence was significantly higher in patients re-treated with a similar regimen than in those re-treated with an alternative regimen (65.4 vs. 11.6%, P < 0.001). In a multivariate Cox regression analysis, B symptoms and a history of drug allergies were identified as risk factors for IP. In conclusion, IP is a life-threatening complication in lymphoma patients. Glucocorticoid therapy with continuous monitoring of chest radiographic changes may be a favourable strategy for treating IP. However, IP may recur, especially in patients re-treated with a similar chemotherapy regimen.

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