Lenalidomide-induced interstitial lung disease.

Area of Science:

• Pulmonology
• Pharmacology
• Oncology

Background:

• Lenalidomide, an oral analog of thalidomide, is used for multiple myeloma and other hematologic disorders.
• Pulmonary toxicity is a rare but serious adverse effect associated with lenalidomide therapy.

Observation:

• A 73-year-old woman developed progressive dyspnea, cough, and hypoxia nine weeks after starting lenalidomide for multiple myeloma.
• Chest CT revealed bilateral interstitial infiltrates, and biopsy showed organizing pneumonia, leading to a diagnosis of lenalidomide-induced interstitial lung disease.

Findings:

• The patient's symptoms and radiologic findings resolved after discontinuing lenalidomide and initiating corticosteroid treatment.
• The Naranjo scale indicated a high probability of lenalidomide being the cause of the adverse drug reaction.

Implications:

• Lenalidomide-induced interstitial lung disease, though uncommon, should be considered in the differential diagnosis for patients on lenalidomide presenting with interstitial lung disease symptoms.
• Potential mechanisms include impaired prostaglandin E2 synthesis or immunologic responses, necessitating clinical vigilance for this rare toxicity.