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Chemical Inactivation of the E3 Ubiquitin Ligase Cereblon by Pomalidomide-based Homo-PROTACs

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Pomalidomide-induced lung injury: A case report

Alexandre Vivien¹, Julien Ancel^1,2, Sophie Godet³

¹Department of Respiratory Diseases, Reims University Hospital, Reims, France.

|January 13, 2023

Abstract

Rationale:

Pomalidomide is an immunomodulatory imide drug used in multiple myeloma and in Kaposi sarcoma.

Patient Concerns:

A 72-years-old male, treated for multiple myeloma with dexamethasone, pomalidomide and daratumumab, presented dyspnea, hypoxemia, biological inflammatory syndrome, ground glass opacities on computed tomography scan (CT-scan) and lymphocytic and eosinophilic alveolitis, with no specific cytologic or microbiological findings, 2 months after pomalidomide initiation.

Intervention And Outcome:

Antibiotics were started after bronchoscopy. No improvement was noted in dyspnea and biological inflammatory syndrome after 5 days of treatment. Pomalidomide was then discontinued, with continuation of Daratumumab-Dexamethasone, resulting in a rapid recovery of symptoms and CT-scan anomalies. No recurrence of dyspnea was observed during the 15 months of follow-up.

Diagnoses:

Pomalidomide-induced lung injury.

Lessons:

Pomalidomide-induced lung injury is a rare and serious adverse event that can occur early after Pomalidomide introduction. As pomalidomide use is increasing, the identification of drug toxicity as a possible cause of lung injury appears important. We report a rapid recovery of symptoms and CT-scan anomalies after pomalidomide discontinuation.

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