Pulmonary complications of cytosine-arabinoside therapy: radiographic findings

Tham, Richard; Peters, W.; Bruïne, FT de; Willemze, R.

doi:10.2214/ajr.149.1.23

Cited by 41 publications

(17 citation statements)

References 11 publications

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“…Andersson et al [2] reported subacute pulmonary failure attributable to cytarabine in 16 of 72 evaluable patients (22%), a mean time of 2-21 days (median = 6) after the first dose. Tham et al [3] studied 64 patients who underwent 66 remission induction courses with intermediate-dose cytarabine and 38 consolidation courses with high-dose cytarabine for treatment of hematologic malignancies. Seven (11%) of 66 induction courses and eight (21%) of 38 consolidation courses were complicated by respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

“…Non-cardiogenic pulmonary edema and acute lung injury/ acute respiratory distress syndrome (ALI/ARDS) complicating cytarabine (Ara-C; cytosine arabinoside) treatment have been previously reported in the literature [1][2][3][4][5][6][7], but remain under-recognized. Here, we describe the case of a patient who developed ARDS secondary to cytarabine treatment and required mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Cytarabine-induced lung injury: case report

Kopterides

Lignos²,

Mentzelopoulos³

et al. 2005

Anti-Cancer Drugs

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We report the case of a 65-year-old male patient with acute myelogenous leukemia who developed severe respiratory failure after receiving cytarabine treatment. Chest radiograph showed bilateral alveolar infiltrates. He was intubated and underwent flexible bronchoscopy. An extensive diagnostic work-up revealed no evidence of infection. Steroids were added to empiric antibiotic treatment and the patient was successfully extubated in 5 days. Cytarabine-induced lung injury should be considered in the differential diagnosis of alveolar infiltrates in immunocompromised patients. If bronchoscopy fails to confirm an infectious cause, a short course of steroids must be tried, which probably leads to a favorable outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cytarabine-induced lung injury: case report

Kopterides

Lignos²,

Mentzelopoulos³

et al. 2005

Anti-Cancer Drugs

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“…NPE is a less well-identified pulmonotoxic syndrome of anticancer therapy. The main clinical characteristics that define NPE are the radiographic findings on chest X-ray that are identical to those seen in congestive heart failure [12]and the potential reversibility of lung damage upon immediate commencement of intensive treatment with corticosteroids. Three cancer therapeutic drugs, cytarabine, gemcitabine and interleukin-2, and some anecdotal cases of single agents, including G-CSF, chemotherapy combinations and megatherapy have been reported to induce NPE, but its pathogenesis remains largely unclear [5, 9, 13, 14, 15, 16].…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy-Induced Noncardiogenic Pulmonary Edema Related to Gemcitabine plus Docetaxel Combination with Granulocyte Colony-Stimulating Factor Support

Briasoulis¹,

Froudarakis

Milionis

et al. 2000

Respiration

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Several cancer therapeutic agents have been associated with pulmonary toxicity. Herein, we describe the case of a 73-year-old woman with breast cancer metastatic to the liver, who developed noncardiogenic pulmonary edema (NPE) while on treatment with gemcitabine plus docetaxel combination with granulocyte colony-stimulating factor (G-CSF) support. Gemcitabine, a deoxycytidine analogue, is reported to produce mild self-limiting and only occasionally severe pulmonary toxicity. The microtubule stabilizer docetaxel has been associated with water retention complications. The combination of these two agents has shown promising activity in several solid tumors and is in a phase of clinical development with prophylactic G-CSF in most of the trials due to the high rate of dose-limiting neutropenia observed with this combination. In our case pulmonary toxicity resolved rapidly following the administration of corticosteroids. A possible deleterious synergy of the compounds involved in this case is discussed and the medical literature on NPE related to cancer therapy is shortly reviewed. We conclude that NPE should always be considered in patients with respiratory function deterioration while on therapy with the gemcitabine-docetaxel combination and G-CSF. Corticosteroids can provide maximum benefit if started early upon diagnosis coupled with withdrawal of the causative drugs.

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“…High concentrations of tumor necrosis factor-alpha and platelet activating factor activity were found in the serum of two of those patients [50]. Finally, a review of radiography findings in patients treated with cytarabine who developed pulmonary complications demonstrated diffuse consolidations of the alveolar pattern in both lungs that regressed within 3 to 7 days in the majority of patients who recovered [15].…”

Section: Cytotoxic Drugsmentioning

confidence: 99%

Noncardiogenic Pulmonary Edema: An Unusual and Serious Complication of Anticancer Therapy

Briasoulis

Pavlidis

2001

The Oncologist

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Noncardiogenic pulmonary edema (NCPE) is a rare and less well-recognizable pulmonotoxic syndrome of anticancer therapy than pneumonitis/fibrosis. NCPE is a clinical syndrome characterized by simultaneous presence of severe hypoxemia, bilateral alveolar infiltrates on chest radiograph, and no evidence of left atrial hypertension/congestive heart failure. The diagnosis of drug-related NCPE relies upon documented exclusion of any infectious, metabolic, or cancer-related causes. The Oncologist 2001;6:153-161 www.TheOncologist.com Correspondence: Evangelos Briasoulis, M.D., Medical Oncology Department, Ioannina University, Ioannina, 45110, Greece. Telephone and Fax: 30-651-99394; e-mail: ebriasou@otenet.gr. Received August 15, 2000; accepted for publication November 30, 2000. ©AlphaMed Press 1083-7159/2001 INTRODUCTIONSeveral cancer therapeutic drugs are known to induce pulmonary damage, which may result in a variety of clinicopathologic syndromes with minor to severe clinical consequences [1]. Clinical syndromes associated with drug-induced pulmonary toxicity include pneumonitis/fibrosis, hypersensitivity lung disease, and noncardiogenic pulmonary edema (NCPE)/acute respiratory distress syndrome (ARDS). These syndromes share a similar symptomatology but differ in regard to the time-relation to cancer treatment, the radiographic findings, the duration of pulmonary damage, and the long-term outcome [2]. Non-specific symptomatology of cough, progressive dyspnea, and often a low-grade fever alert clinicians confronted with the diagnostic challenge to recognize subclinical syndromes and differentiate fully developed drug-induced pulmonary reactions from lung injuries caused by infectious, cardiac, and neoplastic causes.

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Pulmonary complications of cytosine-arabinoside therapy: radiographic findings

Cited by 41 publications

References 11 publications

Cytarabine-induced lung injury: case report

Cytarabine-induced lung injury: case report

Chemotherapy-Induced Noncardiogenic Pulmonary Edema Related to Gemcitabine plus Docetaxel Combination with Granulocyte Colony-Stimulating Factor Support

Noncardiogenic Pulmonary Edema: An Unusual and Serious Complication of Anticancer Therapy

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