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Related Experiment Videos

Lung toxicity associated with cyclophosphamide use. Two distinct patterns

S W Malik1, J L Myers, R A DeRemee

  • 1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.

American Journal of Respiratory and Critical Care Medicine
|December 1, 1996
PubMed
Summary
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Cyclophosphamide can cause lung toxicity, presenting as early-onset reversible pneumonitis or late-onset progressive fibrosis. Recognizing this drug-induced lung disease is crucial for patient outcomes.

Area of Science:

  • Pulmonology
  • Oncology
  • Toxicology

Background:

  • Cyclophosphamide is a widely used chemotherapy agent.
  • Lung toxicity from cyclophosphamide can be challenging to diagnose due to confounding factors.
  • This study aimed to define the clinical spectrum of cyclophosphamide-induced lung toxicity.

Observation:

  • Six patients with cyclophosphamide-induced lung disease were identified over 20 years.
  • Clinical signs included dyspnea, fever, cough, infiltrates, and pleural thickening.
  • Two distinct patterns emerged: early-onset reversible pneumonitis and late-onset progressive pulmonary fibrosis.

Findings:

  • Early-onset pneumonitis responded to drug cessation.
  • Late-onset pneumonitis, associated with pleural thickening, was progressive and unresponsive to treatment.

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  • Three patients with late-onset pneumonitis died from respiratory failure.

    • Implications:

    • Distinguishing cyclophosphamide-induced lung disease from other pulmonary conditions is vital.
    • Early recognition and intervention may improve outcomes for early-onset pneumonitis.
    • Late-onset pulmonary fibrosis presents a poor prognosis, highlighting the need for careful monitoring during cyclophosphamide therapy.