Interstitial lung disease associated with azacitidine use: a case report

Area of Science:

• Oncology
• Pulmonology
• Pharmacology

Background:

• Azacitidine is a hypomethylating agent used to treat myelodysplastic syndromes (MDS).
• It functions by demethylating DNA and reactivating silenced tumor suppressor genes.
• MDS are a group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis and high risk of transformation to acute myeloid leukemia.

Observation:

• A 56-year-old male patient with MDS developed interstitial lung disease (ILD) during azacitidine treatment.
• Lung biopsy showed organizing pneumonia and bronchocentric granulomas, indicative of drug-induced lung injury.
• The Naranjo scale suggested a probable association between azacitidine and ILD.

Findings:

• Discontinuation of azacitidine and initiation of corticosteroid therapy led to the resolution of ILD.
• This case highlights ILD as a potential, albeit uncommon, adverse event associated with azacitidine.
• Subsequent treatment with decitabine did not result in a recurrence of ILD.

Implications:

• Clinicians should be vigilant for ILD symptoms in patients receiving azacitidine therapy.
• Prompt diagnosis and management, including drug withdrawal and anti-inflammatory treatment, are crucial for favorable outcomes.
• Further research is warranted to elucidate the precise mechanisms underlying azacitidine-induced ILD.