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Kars TU, Yaşkıran O, Çeneli Ö. Pneumonitis associated with bortezomib in a patient with multiple myeloma. J Oncol Pharm Pract 2022:10781552221143789. [DOI: 10.1177/10781552221143789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction Bortezomib, which is widely used in the treatment of multiple myeloma (MM), is a proteasome inhibitor and acts by inducing apoptosis. Bortezomib has many side effects, mainly hematological, neurological, and gastrointestinal. A few cases of bortezomib-induced pneumonitis (BIP) have been reported in the literature. Case Report A 51-year-old male patient who was newly diagnosed with MM received bortezomib, cyclophosphamide, and dexamethasone as first-line therapy. In the first cycle, the patient developed dyspnea, tachypnea, and hypoxia after the fourth day of administration of bortezomib monotherapy according to the treatment protocol. Management and outcome Infection and pulmonary involvement of MM were excluded after radiological evaluations, and a diagnosis of BIP was made. Clinical control was achieved quickly with steroid therapy and oxygen support, and radiological findings improved with treatment. Due to this rare side effect of bortezomib, the treatment regimen containing bortezomib was changed. The patient is still receiving treatment that does not contain bortezomib and does not have any pulmonary problems. Discussion In cancer patients receiving treatment, infection and metastasis should be quickly ruled out when pulmonary problems occur, and drug-induced pneumonitis should be considered. This diagnosis, which often responds dramatically to steroids, has the potential to have serious consequences when not considered. In this case, we present bortezomib-associated pneumonitis, a rare side effect of bortezomib. The most important feature of this case is the development of this side effect at the beginning of the treatment, unlike other cases reported in the literature.
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Affiliation(s)
- Taha Ulutan Kars
- Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Osman Yaşkıran
- Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Özcan Çeneli
- Department of Internal Medicine, Division of Hematology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Wirth IM, Peters GE. Bortezomib-induced diffuse alveolar hemorrhage in a patient with plasma cell leukemia. Respir Med Case Rep 2020; 31:101169. [PMID: 32754424 PMCID: PMC7371580 DOI: 10.1016/j.rmcr.2020.101169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 11/04/2022] Open
Abstract
Bortezomib, a chemotherapeutic agent used in the treatment of hematologic malignancies, has been associated with multiple forms of lung injury including diffuse alveolar hemorrhage (DAH). We present the first reported case of bortezomib-induced DAH in a patient with plasma cell leukemia. This 59-year-old female developed hemoptysis, severe cough, and diffuse bilateral ground glass opacities on CT scan of the chest after receiving one dose of bortezomib, with DAH subsequently confirmed on bronchoalveolar lavage. Unlike most previously reported cases, she did not develop respiratory failure requiring high dose corticosteroids, and in fact did not require any supplemental oxygen. We also provide a comparative summary of all reports of bortezomib-induced DAH in the literature to date. This case provides additional insight into the spectrum of disease severity observed in DAH secondary to bortezomib therapy.
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Affiliation(s)
- Ingrid M Wirth
- Division of Respirology, Critical Care, and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gregory E Peters
- Division of Respirology, Critical Care, and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Kreidy M, Al-Hilli A, Yachoui R, Resnick J. Severe but reversible pulmonary hypertension in scleromyxedema and multiple myeloma: a case report. BMC Pulm Med 2020; 20:8. [PMID: 31918690 PMCID: PMC6953266 DOI: 10.1186/s12890-019-1020-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Scleromyxedema is a progressive, systemic connective tissue disorder characterized by fibro-mucous skin lesions and increased serum monoclonal immunoglobulin levels. Pulmonary involvement occurs in a subset of patients, though the overall prevalence of pulmonary lesions in scleromyxedema is unknown. Since pulmonary hypertension presumably occurs in these patients due to disease progression and development of additional conditions, treatment of the underlying plasma cell dyscrasia and connective tissue disorder may improve pulmonary hypertension symptoms. CASE PRESENTATION An elderly patient with scleromyxedema developed pulmonary hypertension refractory to vasodilator and diuretic therapy and subsequently multiple myeloma that responded to a combination therapy of bortezomib, cyclophosphamide, and dexamethasone treatment. CONCLUSIONS Treatment of the underlying disease(s) that contributed to pulmonary hypertension development with anti-neoplastic agents like bortezomib may improve cardiopulmonary symptoms secondary to reducing abnormal blood cell counts and paraprotein levels.
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Affiliation(s)
- Mazen Kreidy
- Department of Pulmonary and Critical Care Medicine, Marshfield Clinic, Marshfield, WI USA
- Present affiliation: Christiana Care Health System, PO Box 1668, Wilmington, DE 19899 USA
| | - Ali Al-Hilli
- Department of Internal Medicine, Marshfield Clinic, Marshfield, WI USA
| | - Ralph Yachoui
- Department of Rheumatology, Ronald Reagan UCLA Medical Center, Santa Monica, California, USA
| | - Jeffrey Resnick
- Department of Pathology, Marshfield Clinic, Marshfield, WI USA
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Kharel P, Uprety D, Chandra AB, Hu Y, Belur AA, Dhakal A. Bortezomib-Induced Pulmonary Toxicity: A Case Report and Review of Literature. Case Rep Med 2018; 2018:2913124. [PMID: 30595697 PMCID: PMC6286773 DOI: 10.1155/2018/2913124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 11/04/2018] [Indexed: 01/10/2023] Open
Abstract
Bortezomib, a proteasome inhibitor, is an established therapy against multiple myeloma. Bortezomib-induced lung injury, although not appreciated during the introductory time of the medication, has now been highlighted in multiple case reports. The objective of this study is to report a case of bortezomib-induced lung injury, review current literature, and perform exploratory analysis.
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Affiliation(s)
- Prakash Kharel
- Department of Hospital Medicine, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17821, USA
| | - Deekchha Uprety
- Renal Division, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Yirui Hu
- Center for Health Research, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17821, USA
| | | | - Ajay Dhakal
- Department of Medicine, Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA
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Li L, Mok H, Jhaveri P, Bonnen MD, Sikora AG, Eissa NT, Komaki RU, Ghebre YT. Anticancer therapy and lung injury: molecular mechanisms. Expert Rev Anticancer Ther 2018; 18:1041-1057. [PMID: 29996062 PMCID: PMC6290681 DOI: 10.1080/14737140.2018.1500180] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Chemotherapy and radiation therapy are two mainstream strategies applied in the treatment of cancer that is not operable. Patients with hematological or solid tumor malignancies substantially benefit from chemotherapeutic drugs and/or ionizing radiation delivered to the site of malignancy. However, considerable adverse effects, including lung inflammation and fibrosis, are associated with the use of these treatment modalities. Areas covered: As we move toward the era of precision health, we are compelled to understand the molecular basis of chemoradiation-induced pathological lung remodeling and to develop effective treatment strategies that mitigate the development of chronic lung disease (i.e. fibrosis) in cancer patients. The review discusses chemotherapeutic agents that are reported to induce or associate with acute and/or chronic lung injury. Expert commentary: There is a need to molecularly understand how chemotherapeutic drugs induce or associate with respiratory toxicities and whether such characteristics are inherently related to their antitumor effect or are collateral. Once such mechanisms have been identified and/or fully characterized, they may be able to guide disease-management decisions including effective intervention strategies for the adverse effects. In the meantime, radiation oncologists should be judicious on the dose of radiation delivered to the lungs, the volume of lung irradiated, and concurrent use of chemotherapeutic drugs.
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Affiliation(s)
- Li Li
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA
- Departmet of Endocrinology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Henry Mok
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Pavan Jhaveri
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Mark D Bonnen
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew G Sikora
- Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - N. Tony Eissa
- Department of Medicine, Section on Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ritsuko U Komaki
- University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Yohannes T Ghebre
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas, USA
- Department of Medicine, Section on Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
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Sugita Y, Ohwada C, Nagao Y, Kawajiri C, Shimizu R, Togasaki E, Yamazaki A, Muto T, Sakai S, Takeda Y, Mimura N, Takeuchi M, Sakaida E, Iseki T, Yokote K, Nakaseko C. Early-Onset Severe Diffuse Alveolar Hemorrhage after Bortezomib Administration Suggestive of Pulmonary Involvement of Myeloma Cells. J Clin Exp Hematop 2016; 55:163-8. [PMID: 26763365 DOI: 10.3960/jslrt.55.163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Severe acute lung injury is a rare but life-threatening complication associated with bortezomib. We report a patient with multiple myeloma who developed a severe diffuse alveolar hemorrhage (DAH) immediately after the first bortezomib administration. The patient was suspected to have pulmonary involvement of myeloma, which caused DAH after rapidly eradicating myeloma cells in the lungs with bortezomib. Rechallenge with bortezomib was performed without recurrent DAH. In patients with multiple myeloma who manifest abnormal pulmonary shadow, we should be aware of early-onset severe DAH after bortezomib administration, which might be due to pulmonary involvement of myeloma cells.
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Balsman E. Bortezomib therapy-related lung disease in a patient with light chain amyloidosis: A case report. J Oncol Pharm Pract 2016; 23:545-548. [PMID: 27357815 DOI: 10.1177/1078155216657680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Bortezomib was the first antineoplastic proteasome inhibitor and is currently indicated for the treatment of hematologic malignancies including multiple myeloma and mantle cell lymphoma. This report describes a 57-year-old patient with light chain (primary) amyloidosis receiving weekly subcutaneous bortezomib injections who presented with recurrent hypoxemia and interstitial pneumonitis. Following the failure of conventional therapy, the patient responded rapidly to high-dose intravenous methylprednisolone. Oxygen therapy was able to be weaned off within three days and he was able to be discharged to home in stable condition, with follow-up computed tomography showing improving lung lesions. Bortezomib is known to rarely cause acute lung injury, but this complication has not been previously described in the setting of amyloidosis. Clinicians should be aware of potentially severe pulmonary adverse effects in all patients treated with bortezomib.
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Li J, Chen S, Hu Y, Cai J. Bortezomib-induced severe pulmonary complications in multiple myeloma: A case report and literature review. Oncol Lett 2016; 11:2255-2260. [PMID: 26998158 DOI: 10.3892/ol.2016.4204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/22/2016] [Indexed: 11/05/2022] Open
Abstract
The proteasome inhibitor bortezomib is indicated for use in the treatment of multiple myeloma (MM) patients. The most common side effects are neurological and gastrointestinal, while severe pulmonary complications are rarely described. The present study reports the case of a 62-year-old man with immunoglobulin (Ig)G-type MM who was treated with bortezomib, thalidomide and dexamethasone. Subsequent to the administration of chemotherapy, the patient developed an acute respiratory distress syndrome. High-resolution computed tomography of the chest showed bilateral diffuse alveolar infiltrations and multiple subpleural lesions. A diagnosis of bortezomib-induced severe pulmonary complications was formed. Systemic corticosteroid therapy led to a rapid improvement in clinical conditions and radiological findings. In addition, the present study reviewed the characteristics, including medical history, clinical manifestations, treatment strategies and outcomes, of all 16 MM patients with bortezomib-induced severe pulmonary complications reported previously in Pubmed. It was indicated that patients who were male, of IgG type, with a relapse status and a previous history of auto-PBSCT had a higher possibility of developing bortezomib-induced severe pulmonary complications. Additionally, a relatively low dose rather than a high dose of corticosteroids could obtain a better outcome.
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Affiliation(s)
- Jingbo Li
- Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Shuda Chen
- Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Yinghong Hu
- Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Jing Cai
- Intensive Care Unit, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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Kaygusuz I, Toptas T, Aydin F, Uzay A, Firatli-Tuglular T, Bayik M. Bortezomib in patients with renal impairment. ACTA ACUST UNITED AC 2014; 16:200-8. [PMID: 21756535 DOI: 10.1179/102453311x13025568941880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Renal failure is a common manifestation of multiple myeloma (MM). Bortezomib is primarily metabolized by cytochrome p450 isoforms. It also has a cytochrome-independent metabolism by excretion through the bile and kidney. Based on our observations, we aimed to explore the efficacy and toxicity profiles of bortezomib in 56 patients with MM, 24 of which had moderate to severe renal failure. Overall response and complete response, as well as very good partial response rates, were comparable between patients with normal renal functions and renal impairment. The median overall survivals for patients with estimated glomerular filtration rates of <60 and ≥60 ml/minute were similar. Although there was a tendency for shorter overall survival along lower estimated glomerular filtration rates, this difference did not reach a statistical significance. Overall and severe adverse events, and dose modification and treatment discontinuation rates were higher in patients with renal impairment. Patients with renal failure had more thrombocytopenia and diarrhea. While thrombocytopenia was mild to moderate and manageable, diarrhea, which led to serious adverse events, was more severe in patients with renal failure who received bortezomib as monotherapy. Bortezomib appears to be active; however, when used alone, it may cause more frequent and severe adverse events in patients with MM and renal failure.
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Affiliation(s)
- Isik Kaygusuz
- Division of Hematology, Marmara University Hospital, Istanbul, Turkey
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Yoshizawa K, Mukai HY, Miyazawa M, Miyao M, Ogawa Y, Ohyashiki K, Katoh T, Kusumoto M, Gemma A, Sakai F, Sugiyama Y, Hatake K, Fukuda Y, Kudoh S. Bortezomib therapy-related lung disease in Japanese patients with multiple myeloma: incidence, mortality and clinical characterization. Cancer Sci 2014; 105:195-201. [PMID: 24329927 PMCID: PMC4317820 DOI: 10.1111/cas.12335] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 12/07/2013] [Accepted: 12/11/2013] [Indexed: 12/21/2022] Open
Abstract
Because of the potentially high mortality rate (6.5%) associated with bortezomib-induced lung disease (BILD) in Japanese patients with relapsed or refractory multiple myeloma, we evaluated the incidence, mortality and clinical features of BILD in a Japanese population. This study was conducted under the Risk Minimization Action Plan (RMAP), which was collaboratively developed by the pharmaceutical industry and public health authority. The RMAP consisted of an intensive dissemination of risk information and a recommended countermeasure to health-care professionals. All patients treated with bortezomib were consecutively registered in the study within 1 year and monitored for emerging BILD. Of the 1010 patients registered, 45 (4.5%) developed BILD, 5 (0.50%) of whom had fatal cases. The median time to BILD onset from the first bortezomib dose was 14.5 days, and most of the patients responded well to corticosteroid therapy. A retrospective review by the Lung Injury Medical Expert Panel revealed that the types with capillary leak syndrome and hypoxia without infiltrative shadows were uniquely and frequently observed in patients with BILD compared with those with conditions associated with other molecular-targeted anticancer drugs. The incidence rate of BILD in Japan remains high compared with that reported in other countries, but the incidence and mortality rates are lower than expected before the introduction of bortezomib in Japan. This study describes the radiographic pattern and clinical characterization of BILD in the Japanese population. The RMAP seemed clinically effective in minimizing the BILD risk among our Japanese population.
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Santalla Martínez M, Blanco Cid N, Dacal Quintas R. Bortezomib-induced lung toxicity. Arch Bronconeumol 2014; 50:564-5. [PMID: 24445175 DOI: 10.1016/j.arbres.2013.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 11/17/2022]
Affiliation(s)
| | - Nagore Blanco Cid
- Servicio de Neumología, Complexo Hospitalario de Ourense, Ourense, España
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13
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Bortezomib with chemotherapy is highly active in advanced B-precursor acute lymphoblastic leukemia: Therapeutic Advances in Childhood Leukemia & Lymphoma (TACL) Study. Blood 2012; 120:285-90. [PMID: 22653976 DOI: 10.1182/blood-2012-04-418640] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Therapy of relapsed pediatric acute lymphoblastic leukemia (ALL) is hampered by low remission rates and high toxicity, especially in second and subsequent relapses. Our phase 1 study, T2005-003, showed that the combination of bortezomib with vincristine, dexamethasone, pegylated asparaginase, and doxorubicin had acceptable toxicity. We report the phase 2 expansion of this combination in patients with relapsed ALL who failed 2-3 previous regimens. Twenty-two patients with relapsed ALL were treated with bortezomib combined with this regimen; their ages ranged from 1 to 22 years, and they had either B-precursor ALL (n = 20) or T-cell ALL (n = 2). Grade 3 peripheral neuropathy developed in 2 (9%) patients. After 3 patients died from bacterial infections, treatment with vancomycin, levofloxacin, and voriconazole prophylaxis resulted in no further infectious mortality in the last 6 patients. Fourteen patients achieved complete remission (CR), and 2 achieved CR without platelet recovery, for an overall 73% response rate, meeting predefined criteria allowing for early closure. B-precursor patients faired best, with 16 of 20 (80%) CR + CR without platelet recovery, whereas the 2 patients with T-cell ALL did not respond. Thus, this combination of bortezomib with chemotherapy is active in B-precursor ALL, and prophylactic antibiotics may be useful in reducing mortality. Bortezomib merits further evaluation in combination therapy in pediatric B-precursor ALL. This study is registered at http://www.clinicaltrials.gov as NCT00440726.
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Yamaguchi T, Sasaki M, Itoh K. Bortezomib-induced pneumonitis during bortezomib retreatment in multiple myeloma. Jpn J Clin Oncol 2012; 42:637-9. [PMID: 22628610 DOI: 10.1093/jjco/hys074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bortezomib is a proteasome inhibitor and is active against multiple myeloma. Most toxicities associated with bortezomib are mild to moderate and manageable; however, bortezomib-induced pneumonitis has been reported in some multiple myeloma cases. Bortezomib-induced pneumonitis was reported to occur relatively soon after the first administration of bortezomib. A 64-year-old Japanese man with multiple myeloma received low-dose dexamethasone followed by bortezomib monotherapy as the initial therapy. He had no pulmonary complications during bortezomib treatment. Thereafter, he was treated with high-dose chemotherapy, followed by autologous peripheral blood stem cell transplantation. Ten months after autologous peripheral blood stem cell transplantation, his disease relapsed and he received bortezomib retreatment. On the fifth day after the second dose of weekly bortezomib, he complained of mild dyspnea, dry cough and fever. High-resolution computed tomography of the chest showed bilateral infiltrates with partial ground glass appearance in the lower lobes. The diagnosis of bortezomib-induced pneumonitis was made. His bortezomib-induced pneumonitis responded to steroid therapy and his respiratory symptoms disappeared. This is the first report in which bortezomib-induced pneumonitis occurred during bortezomib retreatment for relapsed multiple myeloma. Careful management is needed during bortezomib retreatment, even after the previous course of bortezomib was administered safely.
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Affiliation(s)
- Takeshi Yamaguchi
- National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
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Azoulay E. Pleuropulmonary Changes Induced by Drugs in Patients with Hematologic Diseases. PULMONARY INVOLVEMENT IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES 2011. [PMCID: PMC7123804 DOI: 10.1007/978-3-642-15742-4_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patients with hematologic diseases who are being treated with therapy drugs, or receive radiation therapy or blood transfusions may develop a host of potentially fatal infectious and noninfectious pulmonary complications [1]. The increased complexity of multimodality and high-dose treatment regimens with the intended benefit of augmented antineoplastic efficacy and prolonged disease-free survival, the use of a panel of novel drugs to treat malignant and nonmalignant hematologic conditions (e.g., azacytidine, bortezomib, cladribine, dasatinib, fludarabine, imatinib, lenalidomide, rituximab, and thalidomide), total body irradiation (TBI) and hematopietic stem cell transplantation (HSCT) have increased the incidence of severe sometimes life-threatening pulmonary complications.
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Affiliation(s)
- Elie Azoulay
- Service de Réanimation Médicale, Hôpital Saint Louis, Avenue Claude Vellefaux 1, Paris, 75010 France
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Saifee TA, Elliott KJ, Lunn MP, Blake J, Reilly MM, Rabin N, Yong KL, D'Sa S, Brandner S. Bortezomib-induced inflammatory neuropathy. J Peripher Nerv Syst 2010; 15:366-8. [DOI: 10.1111/j.1529-8027.2010.00287.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Dun X, Yuan Z, Fu W, Zhang C, Hou J. Severe pulmonary complications after bortezomib treatment in multiple myeloma. Hematol Oncol 2010; 28:49-52. [PMID: 19728395 DOI: 10.1002/hon.924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Treatment of Human Respiratory Syncytial Virus infected Balb/C mice with the proteasome inhibitor bortezomib (Velcade®, PS-341) results in increased inflammation and mortality. Toxicology 2010; 268:25-30. [DOI: 10.1016/j.tox.2009.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 10/21/2009] [Accepted: 11/12/2009] [Indexed: 11/17/2022]
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Maruyama D, Watanabe T, Heike Y, Nagase K, Takahashi N, Yamasaki S, Waki F, Yokoyama H, Kim SW, Kobayashi Y, Aizawa S, Tobinai K. Stromal cells in bone marrow play important roles in pro-inflammatory cytokine secretion causing fever following bortezomib administration in patients with multiple myeloma. Int J Hematol 2008; 88:396-402. [PMID: 18989635 DOI: 10.1007/s12185-008-0194-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2007] [Revised: 08/13/2008] [Accepted: 09/04/2008] [Indexed: 11/30/2022]
Abstract
Bortezomib blocks the activation of nuclear factor-kappaB-mediated pro-inflammatory cytokines, however, systemic inflammatory symptoms following bortezomib administration have been reported, although their mechanisms remain elusive. Serum samples were obtained from five patients, who participated in a phase I/II study of Japanese patients with relapsed or refractory multiple myeloma (MM), and developed cyclic fever following bortezomib administration, to measure cytokine levels. Significant correlations between interleukin (IL)-6 or interferon (IFN)-gamma and the body temperature were observed in two patients each. Furthermore, we found that IL-6 elevation was not observed after the addition of bortezomib to any examined MM cells alone, but was noted in a case of bone marrow stromal cells (BMSCs) of macrophage origin alone or co-cultured with MM cells. Similarly, a marked increase in IFN-gamma levels was induced by adding bortezomib to BMSCs of fibroblast origin. Although this investigation was a preliminary study with a small number of patients, our results suggested that pro-inflammatory cytokines causing bortezomib-associated fever were secreted from BMSCs rather than MM cells.
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Affiliation(s)
- Dai Maruyama
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takashi Watanabe
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Yuji Heike
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kumiko Nagase
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Noriko Takahashi
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Yamasaki
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Fusako Waki
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroki Yokoyama
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sung-Won Kim
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukio Kobayashi
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shin Aizawa
- Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan
| | - Kensei Tobinai
- Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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