Pulmonary toxicity syndrome following CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) chemotherapy.

Abstract

We report on three patients with multiple myeloma who developed drug-induced pneumonitis 1-2(1/2) months following maintenance (post autologous transplantation) chemotherapy with CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) and 6-20 months after exposure to carmustine (BCNU) 300 mg/m(2), used in combination with melphalan 140 mg/m(2), 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.

• Authors: A Fassas, I Gojo, A Rapoport, M Cottler-Fox, B Meisenberg, J C Papadimitriou, G Tricot
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 28 Issue 4 Pg. 399-403 (Aug 2001) ISSN: 0268-3369 [Print] England
• PMID: 11571514 (Publication Type: Case Reports, Journal Article)

Chemical References

• Etoposide
• Dexamethasone
• Cyclophosphamide
• Cisplatin
• Carmustine

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carmustine (administration & dosage, adverse effects)
• Cisplatin (administration & dosage, adverse effects)
• Combined Modality Therapy (adverse effects)
• Cyclophosphamide (administration & dosage, adverse effects)
• Dexamethasone (administration & dosage, adverse effects)
• Etoposide (administration & dosage, adverse effects)
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Lung Diseases, Fungal (chemically induced, pathology)
• Male
• Middle Aged
• Multiple Myeloma (complications, drug therapy, therapy)
• Pneumonia, Pneumocystis (chemically induced, pathology)
• Syndrome
• Transplantation Conditioning (adverse effects)