Rituximab-induced interstitial lung disease in a patient with follicular lymphoma: A rare case report

Aagre, Suhas; Patel, Apurva; Kendre, Pradip; Anand, Asha

doi:10.4103/0970-2113.168135

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…One such case of rituximab treatment was reported by Aagre et al., wherein a young patient of 33 years, was treated for stage IIIB follicular lymphoma with rituximab. Due to chemotherapy, the patient developed exertional dyspnea and cough, resulting in Rituximab discontinuation 17 . Similar side effects were noticed in a 65‐year‐old female treated with Rituximab‐CHOP chemotherapy for non‐Hodgkin lymphoma, which started with a dry cough and increased significantly after three chemotherapies that the patient needed hospitalization.…”

Section: Discussionmentioning

confidence: 56%

“…Due to chemotherapy, the patient developed exertional dyspnea and cough, resulting in Rituximab discontinuation. 17 Mixed response overall disease progression significantly after three chemotherapies that the patient needed hospitalization. The patient's respiratory status deteriorated so much that she was ventilated, had a cardiac arrest after an episode of self-extubation, and died of multi-organ failure.…”

Section: Discussionmentioning

confidence: 99%

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Ayurveda Rasayana Therapy (ART) leads to tumor regression and increased survival in chemo‐intolerance high‐grade stage IV follicular lymphoma: A case study

Bendale,

Birari‐Gawande,

Patil

et al. 2024

Clinical Case Reports

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Key clinical messageAyurveda Rasayana Therapy (ART) may serve as a safe and effective alternative treatment option for chemo‐intolerance high‐grade stage IV follicular lymphoma patients for increasing survival and tumor regression.AbstractFollicular lymphoma (FL), also called follicle center lymphoma/nodular lymphoma, observed in the B lymphocytes (B‐cells). Available therapeutic options for follicular lymphoma are associated with various side effects and, patients with co‐morbidities can seldom tolerate the chemotherapy regimens. Rasayana therapy not only resulted in tumor regression and improved survival but also dealt with the adverse effects of previous chemotherapy drugs. Herein, we present a case of a 74‐year‐old female diagnosed with Follicular lymphoma who had undergone three cycles of chemotherapy with unresolved disease outcome and serious adverse events. The patient refused to undergo further cycles of chemotherapy. Her family decided to start Ayurveda treatment for her as an alternative therapy for cancer care. On thorough case taking considering the Ayurveda parameters personalized Rasayana therapy as planned for the patient with an aim for improvement in Quality of Life (QoL), increasing survival, and optimizing body's immune response to fight the tumor. After treatment of 8 months, this case demonstrated partial tumor response as evidenced by PET‐CT‐scan. Quality of Life as evaluated using FACT‐G was also seen improved besides significant improvement in physical performance status evaluated using ECOG. The patient showed a survival of 3.5 years after starting Ayurveda Rasayana Therapy (ART). Rasayana therapy was well tolerated by the patient. This case report indicates the potential role of ART as a therapeutic option in geriatric cancer patients who are not eligible for cytotoxic interventions. Case warrants further systematic investigation to evaluate the potential role of ART in the treatment of geriatric cancer patients.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Ayurveda Rasayana Therapy (ART) leads to tumor regression and increased survival in chemo‐intolerance high‐grade stage IV follicular lymphoma: A case study

Bendale,

Birari‐Gawande,

Patil

et al. 2024

Clinical Case Reports

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“…The mechanism underlying RTX-ILD is still not well understood; however, multiple mechanisms that could contribute to lung injury have been proposed, including cytotoxic T lymphocyte dysregulation due to prolonged B-cell depletion, leuco-stasis in the pulmonary circulation, the release of inflammatory cytokines, and tumor lysis syndrome [ 3 , 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Concomitant Lung Disease and Hepatitis After Rituximab Treatment: A Case Report

Albusoul¹,

Abunafeesa²,

Dabak³

2023

Cureus

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Rituximab (RTX) is a chimeric monoclonal antibody that is a standard component of treatment for all B-cell malignancies. The most common adverse events related to RTX are infusion-related reactions, such as fever, chills, urticaria, flushing, and headaches. However, RTX-induced lung disease (RTX-ILD) is a rare but potentially fatal adverse reaction, and diagnosing RTX-ILD is challenging, especially when accompanied by other rare adverse reactions, such as hepatitis. Here, we report a case of RTX-ILD with concomitant RTX-induced hepatitis in a 55-year-old man with follicular B-cell non-Hodgkin lymphoma who was on maintenance RTX therapy. The patient presented with a subacute, persistent dry cough, shortness of breath, fevers, and chills shortly after having traveled. Outpatient antibiotic therapy did not relieve symptoms, and laboratory studies revealed evidence of liver injury. A computed tomography (CT) of the chest showed predominately basilar airspace disease and ground glass opacities suggestive of multifocal pneumonia. Extensive infectious and autoimmune workups were negative. RTX-ILD with concomitant RTX-induced hepatitis was considered because antibiotic therapy did not resolve symptoms or improve signs of liver damage. Prednisone (1 mg/kg) led to symptom resolution and liver enzyme improvement. The patient underwent a 30-day steroid taper and the withholding of RTX infusions. A CT of the chest three months after discharge showed nearly resolved multifocal ground glass opacities. RTX-ILD should be considered after infectious and autoimmune etiologies have been ruled out for all patients on RTX therapy who experience symptoms of lung pathology or infection.

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“…На страницах периодической печати этой проблеме посвящены единичные казуистические наблюдения и обзоры [8][9][10]. В 2012 г.…”

Section: Introductionunclassified

Rituximab-induced interstitial pneumonitis in patient with non-Hodgkin lymphoma: a clinical case

Огнерубов

Antipova²

2022

Consilium Medicum

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Rituximab is a chimeric monoclonal antibody against CD20+ lymphocytes used to treat non-Hodgkin lymphoma, hematological and autoimmune diseases rheumatoid arthritis, systemic lupus erythematosus, thrombocytopenic purpura, hemolytic anemia, multiple sclerosis. The safety of the drug is critical to the choice of treatment. Rituximab-associated interstitial lung disease is rare. Objective. To describe a case of interstitial pneumonitis induced by rituximab in monotherapy at the end of maintenance therapy. Materials and methods. We describe a case of a 37-year-old patient with stage IIB non-Hodgkin lymphoma involving palatine tonsils and cervical and submandibular lymph nodes on both sides. Histologically, this tumor was a diffuse large B-cell lymphoma. Results. A patient received six R-CHOP courses of chemotherapy and immunotherapy for stage IIB diffuse large B-cell lymphoma. After the therapy, a complete clinical and metabolic response was achieved. Rituximab maintenance therapy was administered at a dose of 375 mg/m2 every 2 months for 2 years. At this treatment stage, combined positron emission tomography and 18F-fluorodeoxyglucose computed tomography (PET/CT with 18F-FDG) was performed at 45 months intervals. No radiological signs of pulmonary diseases were detected. Seven weeks after the last dose of rituximab (24 months), another PET/CT with 18F-FDG showed radiological changes that were considered to be interstitial pneumonitis, with no respiratory signs of the disease. No signs of tumor progression were found. Conclusion. Rituximab may contribute to late pulmonary toxicity presented as interstitial pneumonitis in non-Hodgkin lymphoma patients at a young age after maintenance therapy for 24 months. PET/CT with 18F-FDG is the primary method of diagnosing pulmonary toxicity.

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Rituximab-induced interstitial lung disease in a patient with follicular lymphoma: A rare case report

Cited by 8 publications

References 10 publications

Ayurveda Rasayana Therapy (ART) leads to tumor regression and increased survival in chemo‐intolerance high‐grade stage IV follicular lymphoma: A case study

Ayurveda Rasayana Therapy (ART) leads to tumor regression and increased survival in chemo‐intolerance high‐grade stage IV follicular lymphoma: A case study

A Rare Presentation of Concomitant Lung Disease and Hepatitis After Rituximab Treatment: A Case Report

Rituximab-induced interstitial pneumonitis in patient with non-Hodgkin lymphoma: a clinical case

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