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Published on: April 12, 2019
BCNU toxicity presenting with a large pericardial and pleural effusion
Ganapathy S Krishnan1, Vijay Chaudhary, Anas Al-Janadi
1Department of Internal Medicine, Division of Hematology and Oncology, Michigan State University, E. Lansing, MI, USA. ganakrish@gmail.com
Annals of Transplantation
|March 18, 2008
Summary
Carmustine (BCNU) therapy can cause rare but serious cardiopulmonary toxicity, including cardiac tamponade. Early glucocorticoid treatment may reduce this risk in patients undergoing stem cell transplantation.
Area of Science:
- Oncology
- Pharmacology
- Cardiology
Background:
- Carmustine (BCNU) is an alkylating agent used in conditioning regimens for autologous peripheral blood stem cell transplantation.
- While BCNU is widely used in adults, its association with cardiopulmonary toxicity, specifically cardiac tamponade, has not been previously documented.
Observation:
- A case report details a patient who developed bilateral upper lobe pulmonary infiltrates, pleural effusions, and a large pericardial effusion after receiving BCNU.
- These symptoms were attributed to BCNU-induced toxicity.
Findings:
- The patient's presentation of pulmonary infiltrates and effusions, alongside pericardial effusion, represents a significant manifestation of BCNU's adverse effects.
- This case highlights a previously unreported form of cardiopulmonary toxicity associated with BCNU therapy.
Implications:
- Early administration of glucocorticoids in patients receiving high-dose BCNU-containing regimens may mitigate the risk of cardio-pulmonary toxicity.
- This finding suggests a potential preventative strategy for managing BCNU-related adverse events in stem cell transplantation protocols.
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