Abstract
We report on three patients with multiple myeloma who developed drug-induced pneumonitis 1–2½ months following maintenance (post autologous transplantation) chemotherapy with CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) and 6–20 months after exposure to carmustine (BCNU) 300 mg/m2, used in combination with melphalan 140 mg/m2, as pre-transplant conditioning regimen. All patients had either a proven (two) or suspected (one) fungal pneumonia and were treated with liposomal amphotericin B. Dyspnea, fever and cough were the prominent clinical symptoms, while air-space disease with ground glass appearance was seen radiographically. Histologic features typical for drug-induced lung injury were detected. All patients had a dramatic, clinical and radiographic response to a brief course of corticosteroids. Although CDEP-induced pneumonitis appears to be a rare complication, its early recognition and prompt treatment, as well as its possible association with preceding fungal infection may have important clinical implications. Bone Marrow Transplantation (2001) 28, 399–403.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Kreisman H, Wolkove N . Pulmonary toxicity of antineoplastic therapy Semin Oncol 1992 19: 508–520
Zimmerman MS, Ruckdeschel JC, Hussain M . Chemotherapy-induced interstitial pneumonitis during treatment of small cell anaplastic lung cancer J Clin Oncol 1984 2: 396–405
Wilczynski SW, Erasmus JJ, Petros WP et al. Delayed pulmonary toxicity syndrome following high-dose chemotherapy and bone marrow transplantation for breast cancer Am J Respir Crit Care Med 1998 157: 565–573
Tricot G, Fassas A, Rapoport A et al. Post-transplantation (PT) intensive chemotherapy is feasible and results in prompt and complete hematologic recovery in patients with multiple myeloma and low grade lymphoma ASH 1999 1485: 332a (Abstr.)
O'Driscoll BR, Hasleton PS, Taylor PM et al. Active lung fibrosis up to 17 years after chemotherapy with carmustine (BCNU) in childhood New Engl J Med 1990 323: 378–382
Rubio C, Hill ME, Milan S et al. Idiopathic pneumonia syndrome after high-dose chemotherapy for relapsed Hodgkin's disease Br J Cancer 1997 75: 1044–1048
Todd NW, Peters WP, Ost AH et al. Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation Am Rev Respir Dis 1993 147: 1264–1270
Spector JI, Zimbler H, Ross JS . Early-onset cyclophosphamide-induced interstitial pneumonitis JAMA 1979 242: 2852–2854
Malik SW, Myers JL, DeRemee RA, Specks U . Lung toxicity associated with cyclophosphamide use. Two distinct patterns Am J Respir Crit Care Med 1996 154: 1851–1856
Bhalla KS, Wilczynski SW, Abushamaa AM et al. Pulmonary toxicity of induction chemotherapy prior to standard or high-dose chemotherapy with autologous hematopoietic support Am J Respir Crit Care Med 2000 161: 17–25
Rahman Z, Kavanagh J, Champlin R et al. Chemotherapy immediately following autologous stem-cell transplantation in patients with advanced breast cancer Clin Cancer Res 1998 4: 2717–2721
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fassas, A., Gojo, I., Rapoport, A. et al. Pulmonary toxicity syndrome following CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) chemotherapy. Bone Marrow Transplant 28, 399–403 (2001). https://doi.org/10.1038/sj.bmt.1703147
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1703147
