Side Effects and Good Effects from New Chemotherapeutic Agents

Onozawa, Masahiro; Hashino, Satoshi; Sogabe, Susumu; Haneda, Masahira; Horimoto, Hiromasa; Izumiyama, Koh; Kondo, Takeshi; Aldana, Luis Perez; Hamada, Kunio; Asaka, Masahiro

doi:10.1200/jco.2005.04.054

Cited by 33 publications

(8 citation statements)

References 4 publications

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“…Abdominal discomfort resulting from constipation is also a well-recognised side effect of thalidomide and can be readily assessed radiologically using a supine plain radiograph of abdomen. A reported side effect is interstitial pneumonitis which can be identified on high-resolution CT [ 82 ] . The drug bortezomib is associated with cytopaenia and a decrease in platelet count to <50,000 mm 3 occurs in almost 30% of patients increasing the risk of haemorrhage [ 83 ] .…”

Section: Side Effects Of Therapy and Complications: The Role Of Radiomentioning

confidence: 99%

Multiple myeloma

Collins¹

2010

Cancer Imaging

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Section: Side Effects Of Therapy and Complications: The Role Of Radiomentioning

confidence: 99%

Multiple myeloma

Collins¹

2010

Cancer Imaging

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“…Only one case of thalidomide-induced interstitial pneumonitis5 and one case of bortezomib-induced interstitial pneumonitis have been reported so far 6. None of the previous two ILD cases were confirmed by biopsy, thus the subtype is not known.…”

Section: Discussionmentioning

confidence: 97%

Nonspecific Interstitial Pneumonitis after Bortezomib and Thalidomide Treatment in a Multiple Myeloma Patient

et al. 2010

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Bortezomib, an inhibitor of 26S proteosome, is recently approved treatment option for multiple myeloma. Thalidomide, a drug with immunomodulating and antiangiogenic effects, has also shown promise as an effective treatment in multiple myeloma. Pulmonary complications are believed to be rare, especially interstitial lung disease. Here, we describe a patient with dyspnea and diffuse pulmonary infiltrates while receiving bortezomib and thalidomide in combination with dexamethasone for treatment-naïve multiple myeloma. Bronchoalveolar lavage demonstrated a significant decrease in the ratio of CD4 : CD8 T lymphocytes (CD4/8 ratio, 0.54). Extensive workup for other causes, including infections, was negative. A lung biopsy under video-assisted thorascopic surgery revealed a diagnosis of nonspecific interstitial pneumonitis. The symptoms and imaging study findings improved after initiating steroid treatment. Physicians should be aware of this potential complication in patients receiving the novel molecular-targeted antineoplastic agents, bortezomib and thalidomide, who present with dyspnea and new pulmonary infiltrates and fail to improve despite treatment with broad-spectrum antibiotics.

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“…In 2005, a case of typical interstitial pneumonia induced by thalidomide was reported [9]. Chest CT showed diffuse interstitial infiltration and cultures of BALF and sputum obtained by bronchoscopy were negative.…”

Section: Discussionmentioning

confidence: 99%

“…Thalidomide-induced interstitial pneumonia should be suspected in patients who develop dyspnea, cough, and fever after taking thalidomide, without a definite cause, when the chest X-ray shows a diffuse pulmonary infiltration [4-6,9]. …”

Section: Discussionmentioning

confidence: 99%

Thalidomide Induced Nonspecific Interstitial Pneumonia in Patient with Relapsed Multiple Myeloma

Kang

Kim

et al. 2010

Korean J Intern Med

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A 63-year-old female diagnosed with relapsed multiple myeloma visited our hospital complaining of a persistent cough. Since July 2006, she had been taking 100 mg thalidomide daily and gradually developed shortness of breath and a persistent dry cough. A chest X-ray and computed tomography showed ground glass opacities in both lungs. An open lung biopsy of the right middle lobe under general anesthesia revealed chronic peribronchial inflammation, mild interstitial fibrosis, and intra-alveolar macrophage infiltration, with some hemosiderin features, compatible with non-specific interstitial pneumonia (NSIP). After discontinuing the thalidomide, the patient's symptoms did not deteriorate, although the radiographs did not improve. The patient is alive and well with regular outpatient follow-up without progression of the NSIP.

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Side Effects and Good Effects from New Chemotherapeutic Agents

Cited by 33 publications

References 4 publications

Multiple myeloma

Multiple myeloma

Nonspecific Interstitial Pneumonitis after Bortezomib and Thalidomide Treatment in a Multiple Myeloma Patient

Thalidomide Induced Nonspecific Interstitial Pneumonia in Patient with Relapsed Multiple Myeloma

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