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Busulfan therapy for chronic myelogenous leukemia can cause fatal pulmonary fibrosis, known as "busulfan lung." This report details the first pediatric case in a 16-month-old infant, highlighting the drug
Area of Science:
- Pediatric Oncology
- Pulmonary Medicine
- Toxicology
Background:
- Busulfan is a chemotherapy agent used for chronic myelogenous leukemia.
- Pulmonary fibrosis is a rare but lethal side effect of busulfan therapy.
Observation:
- A 16-month-old infant received busulfan for 11 months.
- The infant developed progressive lung changes consistent with diffuse intra-alveolar and interstitial fibrosis.
- The patient experienced acute respiratory distress and expired.
Findings:
- Histological examination revealed characteristic busulfan-induced lung and pancreatic changes.
- Autopsy excluded infection or leukemic infiltration as causes of lung pathology.
- This case represents the first reported instance of busulfan lung in a pediatric patient.
Implications:
- Highlights the potential for busulfan-induced pulmonary toxicity in pediatric patients.
- Emphasizes the need for vigilant monitoring of lung function in children undergoing busulfan therapy.
- Underscores the importance of considering drug-induced lung disease in pediatric respiratory failure.
Abstract:
An uncommon, but lethal, toxic side effect of busulfan (Myleran) therapy for chronic myelogenous leukemia is pulmonary fibrosis. A 16-month-old male infant treated for 11 months with busulfan for chronic myelogenous leukemia is, we believe, the first case of "busulfan lung" in the pediatric age group to be reported. Progressive roentgenographic changes in the lung of a diffuse intra-alveolar and interstitial pattern were noted. The patient died after a four-day episode of cough, fever, and progressive dyspnea. At autopsy, no evidence of infection or leukemic infiltrates were seen in the lungs. Characteristic histologic findings as a result of busulfan therapy were observed in the lung and pancreas.