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Saglam B, Kalyon H, Ozbalak M, Ornek S, Keske S, Tabak L, Cakar N, Zeren H, Aytekin S, Bolukbasi Y, Ferhanoglu B. Bortezomib induced pulmonary toxicity: a case report and review of the literature. AMERICAN JOURNAL OF BLOOD RESEARCH 2020; 10:407-415. [PMID: 33489450 PMCID: PMC7811899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/22/2020] [Indexed: 06/12/2023]
Abstract
Bortezomib is widely used in the treatment of Multiple Myeloma. While the most common side effects are neurological and gastrointestinal related complications, severe pulmonary problems are rarely described. The present case is a 72-year old male with multiple myeloma, who received Lenalidomide, Bortezomib, and Dexamethasone (RVD) combination regimen. He underwent 30 Gy palliative radiotherapy to the thoracic 5-9 and lumbar L1-3 vertebra due to pain and fracture risk. During the third cycle, he was admitted to hospital with dyspnea and dizziness. The thoracic CT revealed bilateral pleural effusions, a diffuse reticular pattern on the parenchyma, and ground-glass opacities that were compatible with drug-induced lung injury. The microbiological and molecular analysis excluded infectious disease, and lung biopsy confirmed the diagnosis of Bortezomib Lung Injury. The time from the first dose of Bortezomib to the lung injury was 57 days, and it was five days from the last dose of Bortezomib. His symptoms were refractory to IV steroids and supportive care. Our patient was lost despite steroids and intensive care support. Even Bortezomib induced lung injury is a rare adverse effect, based on high mortality rate, we would like to emphasize the clinical importance of this clinical scenario in light of the published literature and our presented case.
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Affiliation(s)
- Burcin Saglam
- Department of Internal Medicine, School of Medicine, Koç UniversityIstanbul, Turkey
| | - Hakan Kalyon
- Department of Hematology, American HospitalIstanbul, Turkey
| | - Murat Ozbalak
- Division of Hematology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul UniversityIstanbul, Turkey
| | - Serdar Ornek
- Department of Hematology, American HospitalIstanbul, Turkey
| | - Siran Keske
- Department of Infectious Diseases and Clinical Microbiology, American HospitalIstanbul, Turkey
| | - Levent Tabak
- Department of Respiratory Medicine, School of Medicine, Koç UniversityIstanbul, Turkey
| | - Nahit Cakar
- Department of Anesthesiology and Reanimation, School of Medicine, Koç UniversityIstanbul, Turkey
| | - Handan Zeren
- Department of Pathology, School of Medicine, Acıbadem UniversityIstanbul, Turkey
| | - Saide Aytekin
- Department of Cardiology, School of Medicine, Koç UniversityIstanbul, Turkey
| | - Yasemin Bolukbasi
- Department of Radiation Oncology, School of Medicine, Koç UniversityIstanbul, Turkey
| | - Burhan Ferhanoglu
- Department of Hematology, School of Medicine, Koç UniversityIstanbul, Turkey
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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 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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