Pomalidomide-induced acute eosinophilic pneumonia: a case report

Area of Science:

• Pulmonology
• Oncology
• Pharmacology

Background:

• Drug-induced lung injury is an infrequent complication of various medications, including cancer therapies.
• Eosinophilic pneumonia is a rare pulmonary toxicity associated with immunomodulatory drugs like thalidomide and lenalidomide.
• Pomalidomide, a third-generation immunomodulatory agent, is used for relapsed or refractory multiple myeloma, with limited documented cases of lung injury.

Purpose of the Study:

• To report a rare case of eosinophilic pneumonia.
• To attribute the condition to pomalidomide exposure.
• To emphasize prompt diagnosis and management of this adverse drug reaction.

Main Methods:

• A case presentation of a 67-year-old patient with relapsed multiple myeloma.
• Diagnostic workup included respiratory symptoms, imaging, bronchoalveolar lavage, and exclusion of other causes.
• Treatment involved pomalidomide withdrawal and systemic corticosteroid therapy.

Main Results:

• The patient developed eosinophilic pneumonia during treatment with daratumumab, pomalidomide, and dexamethasone.
• Bronchoalveolar lavage showed significant eosinophilia.
• Discontinuation of pomalidomide and initiation of corticosteroids resulted in rapid clinical and radiological improvement.

Conclusions:

• Pomalidomide can induce eosinophilic pneumonia, a rare but serious adverse event.
• Prompt recognition, drug discontinuation, and corticosteroid treatment are crucial for favorable outcomes.
• Sustained pulmonary function recovery was observed at 12-month follow-up.