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Pulmonary toxicity associated with fludarabine monophosphate
P G Hurst1, M P Habib, H Garewal
1Medical Service, Veterans Administration Medical Center, Tucson, Arizona.
Abstract:
Fludarabine monophosphate (FAMP), the 2-fluoro, 5' phosphate derivative of 9-beta-D-arabinofuranosyl adenine (ara-A), is a purine nucleoside antimetabolite presently undergoing clinical testing for the treatment of a variety of malignancies including lymphoproliferative disorders and acute leukemia. We report a case of diffuse interstitial pneumonitis during treatment of chronic lymphocytic leukemia with FAMP. This resolved quickly with high dose steroids, recurred with steroid withdrawal, and abated with further steroid therapy. To our knowledge, this is the first reported case of fludarabine monophosphate associated pulmonary toxicity.
Insights
Fludarabine monophosphate (FAMP) can cause lung toxicity in leukemia patients. This interstitial pneumonitis resolved with steroids but returned upon withdrawal, highlighting a potential adverse effect of this cancer drug.
Area of Science:
- Oncology
- Pulmonology
- Pharmacology
Background:
- Fludarabine monophosphate (FAMP), a purine nucleoside antimetabolite, is used to treat various cancers like chronic lymphocytic leukemia (CLL).
- FAMP is a derivative of 9-beta-D-arabinofuranosyl adenine (ara-A).
Observation:
- A case of diffuse interstitial pneumonitis was observed in a patient undergoing treatment for CLL with FAMP.
- The pulmonary toxicity presented as interstitial pneumonitis.
Findings:
- The interstitial pneumonitis resolved rapidly with high-dose corticosteroid therapy.
- The condition recurred upon steroid withdrawal and abated again with further steroid administration.
Implications:
- This is the first reported instance of pulmonary toxicity associated with fludarabine monophosphate.
- The findings suggest a need for vigilance regarding FAMP-induced lung injury and prompt management with steroids.