Deceptive Lungs: Is it Brentuximab Induced Pneumonitis or Pneumonia

Syeda, Afsarunnesa; Mohammed, Tan-Lucien H.; Mir, Mahnoor

doi:10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2123

Cited by 3 publications

(4 citation statements)

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“…In 1 retrospective study of 123 adult and pediatric patients receiving BV for cHL, 5% developed pneumonitis, 27 and several other case reports have detailed the finding. 28 , 29 , 30 , 31 Our findings emphasize the need to consider BV-associated pneumonitis in patients who develop pulmonary symptoms during treatment.…”

Section: Discussionmentioning

confidence: 65%

Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort

Bowers,

Anna,

Bair

et al. 2023

Blood Advances

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Introduction: Brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) is increasingly used for frontline treatment of stage III/IV classical Hodgkin lymphoma (cHL). Peripheral neuropathy (PN) was the most common and treatment-limiting side effect seen in clinical trials but has not been studied in a non-trial setting, where clinicians may have different strategies for managing it. Methods: We conducted a multi-site retrospective study to characterize PN in patients who received BV+AVD for newly diagnosed cHL. Results: 153 patients from 10 US institutions were eligible. Thirty-four patients (22%) had at least 1 ineligibility criteria for ECHELON-1, including stage, performance status, and comorbidities. PN was reported by 80% of patients during treatment; 39% experienced grade (G) 1, 31% G2, and 10% G3. In total, BV was modified in 44% of patients due to PN leading to BV discontinuation in 23%, dose reduction in 17%, and temporary hold in 4%. With a median follow up of 24 months, PN resolution was documented in 36% and improvement in 33% at last follow up. 2-year progression-free survival (PFS) for the advanced stage patients was 82.7% (95% CI 0.76-0.90) and overall survival (OS) was 97.4% (95% CI 0.944-1.00). Patients who discontinued BV due to PN did not have inferior PFS. Conclusions: In the non-trial setting, BV+AVD was associated with a high incidence of PN. In our cohort, which includes patients who would not have been eligible for the pivotal ECHELON-1 trial, BV discontinuation rates were higher than previously reported, but 2-year outcomes remain comparable.

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Section: Discussionmentioning

confidence: 65%

Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort

Bowers,

Anna,

Bair

et al. 2023

Blood Advances

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“…However, the anatomical distribution was not consistent suggesting no zonal predominance. In four out of the five cases, the opacities were diffuse and scattered 10 – 12 , 14 , while another case reported lower lobe predominance 13 . In contrast, our case exhibited upper lobe predominance with the presence of a reversed halo sign.…”

Section: Discussionmentioning

confidence: 81%

“…Within the documented cases, BV-induced pneumonitis shows a diverse and unpredictable pattern of toxicity, with symptoms appearing at different times among reported cases, indicating a likely idiosyncratic reaction 10 – 14 . In the reported cases, cough was a prevalent presentation of BV-induced lung injury 10 – 13 . Most cases had a dry cough, although a productive cough was reported at least once 13 .…”

Section: Discussionmentioning

confidence: 98%

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Brentuximab-induced pneumonitis and organizing pneumonia: A case report with literiture review

Khalil,

Mallah,

Owda

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Brentuximab Vedotin (BV) is an anti-CD30 antibody approved for various cancers, including refractory Hodgkin lymphoma (HL), anaplastic large cell lymphoma (ALCL) among others. In general, BV has been found to be well-tolerated, with the most frequently reported side effects being peripheral neuropathy and neutropenia. BV-induced pneumonitis is extremely rare. To the best of our knowledge, this is the sixth reported instance of BV-induced lung toxicity. Case Presentation: This case presents a female patient in her forties diagnosed with Cutaneous T cell Lymphoma undergoing BV treatment. She developed acute hypoxic respiratory failure, ultimately, underwent a diagnostic evaluation including a CT scan, which showed bilateral airspace consolidations and ground-glass opacities, suggestive of organizing pneumonia and diffuse alveolar damage. Bronchoscopy with BAL and transbronchial biopsy ruled out infection, and pulmonary lymphoma and confirmed the diagnosis of BV-induced pneumonitis. The patient had significant clinical improvement after stopping the offending agent, and starting steroids, with optimal clinical recovery at 8 weeks follow-up. Clinical Discussion: Drug-related pneumonitis poses a significant concern in the management of cancer patients. Numerous chemotherapeutic agents, such as bleomycin, cyclophosphamide, methotrexate, thalidomide, and others, have been associated with pulmonary-related toxicities. These adverse effects primarily stem from direct toxicity or immunosuppression-related infections. Less commonly, immune-mediated injury may occur. Conclusion: Physicians must have a high index of suspicion for BV-induced pneumonitis, hence, early recognition with subsequent holding of the causative agent, initiation of immunosuppression with steroids, and occasionally steroid-sparing medications, prevent an otherwise fatal outcome.

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Brentuximab vedotin

2021

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Deceptive Lungs: Is it Brentuximab Induced Pneumonitis or Pneumonia

Cited by 3 publications

References 0 publications

Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort

Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort

Brentuximab-induced pneumonitis and organizing pneumonia: A case report with literiture review

Brentuximab vedotin

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