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Azacitidine-induced acute lung injury in a patient with therapy-related myelodysplastic syndrome
Shinichi Makita1, Wataru Munakata1, Daisuke Watabe2
11 Departments of Hematology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
Abstract:
Azacitidine is a first-in-class demethylating agent, and it is widely used globally as a first-line treatment for higher-risk myelodysplastic syndrome (MDS). Here, we report the case of a patient with MDS who suffered from a rare adverse event, an acute lung injury (ALI), which was suspected to have been caused by azacitidine and was successfully treated with corticosteroids. As it is a rare, but critical, adverse event, clinicians should consider ALI as one of the differential diagnoses in cases where 1) pneumonia and fever of unknown etiology arise in MDS patients treated with azacitidine, 2) antimicrobial agents are not effective, and 3) microbiological tests produce negative results.
Insights
This case report details a rare but serious adverse event: acute lung injury (ALI) in a myelodysplastic syndrome (MDS) patient treated with azacitidine. Prompt corticosteroid treatment led to successful recovery.
Area of Science:
- Hematology
- Pulmonology
- Pharmacology
Background:
- Azacitidine is a key first-line therapy for higher-risk myelodysplastic syndrome (MDS).
- Adverse events associated with azacitidine require careful monitoring and differential diagnosis.
- Myelodysplastic syndromes encompass a group of clonal hematopoietic stem cell disorders.
Observation:
- A patient with MDS developed acute lung injury (ALI) during azacitidine treatment.
- The ALI was suspected to be an adverse reaction to azacitidine.
- Symptoms included pneumonia and fever of unknown origin, unresponsive to antimicrobials.
Findings:
- The patient's ALI was successfully treated with corticosteroids.
- This case highlights a rare but critical adverse event linked to azacitidine therapy.
- Diagnostic criteria include unexplained pneumonia/fever in azacitidine-treated MDS patients with negative microbiology.
Implications:
- Clinicians should consider azacitidine-induced ALI in differential diagnoses for MDS patients.
- Early recognition and corticosteroid treatment can improve outcomes for this rare adverse event.
- This underscores the importance of vigilant pharmacovigilance in MDS treatment.
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