Acute respiratory distress syndrome after chemotherapy for lung metastases from non-seminomatous germ-cell tumors

Kirch, Christoph; Blot, François; Fizazi, Karim; Raynard, Bruno; Théodore, Christine; Nitenberg, Gérard

doi:10.1007/s00520-003-0481-5

Cited by 26 publications

(36 citation statements)

References 25 publications

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“…Therefore we consider that chemotherapy was responsible for triggering hemorrhage. The authors also concluded that patients with moderate hypoxemia (PaO 2 [70 mmHg) could receive the first chemotherapy on a general ward, while more severely hypoxemic patients should be transferred to the ICU [10].…”

Section: Discussionmentioning

confidence: 99%

A case of metastatic testicular cancer complicated by pulmonary hemorrhage due to choriocarcinoma syndrome

Kandori

Kawai²,

Fukuhara³

et al. 2010

Int J Clin Oncol

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A 40-year-old man was referred to our hospital for treatment of metastatic testicular cancer. Computerized tomography revealed multiple lung, liver, and retroperitoneal lymph node metastases. In addition, magnetic resonance imaging revealed multiple brain metastases. Induction chemotherapy with bleomycin, etoposide, and cisplatin was started the day after a high orchiectomy. The pathological diagnosis of the surgical specimen was yolk sac carcinoma. The serum human chorionic gonadotropin (hCG) was markedly increased to 630,000 mIU/ml, which suggested the presence of a choriocarcinoma element at metastatic sites. The patient subsequently suffered respiratory failure due to pulmonary hemorrhage. Intensive supportive care prevented a fatal outcome. Physicians who treat advanced testicular tumors should be aware of the potential complication of acute pulmonary hemorrhage, called choriocarcinoma syndrome, in cases with a high hCG level, which indicates a rapidly progressive and high-volume choriocarcinoma.

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Section: Discussionmentioning

confidence: 99%

A case of metastatic testicular cancer complicated by pulmonary hemorrhage due to choriocarcinoma syndrome

Kandori

Kawai²,

Fukuhara³

et al. 2010

Int J Clin Oncol

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“…All of our three patients became severely ill with acute renal failure, acute respiratory failure, and shock. Kirch and colleagues[4] reported 16 patients with germ-cell tumors with diffuse pulmonary metastases who developed acute respiratory failure following the start of chemotherapy. Out of them, nine required mechanical ventilation and all but one patient died.…”

Section: Discussionmentioning

confidence: 99%

Severe acute tumor lysis syndrome in patients with germ-cell tumors

Feres¹,

Salluh²,

Ferreira³

et al. 2008

Indian J Urol

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Germ-cell tumors are a high-proliferative type of cancer that may evolve to significant bulky disease. Tumor lysis syndrome is rarely reported in this setting. The reports of three patients with germ-cell tumors who developed severe acute tumor lysis syndrome following the start of their anticancer therapy are presented. All patients developed renal dysfunction and multiorgan failure. Patients with extensive germ-cell tumors should be kept on close clinical and laboratory monitoring. Physicians should be aware of this uncommon but severe complication and consider early admission to the intensive care unit for the institution of measures to prevent acute renal failure.

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“…To date, it remains unclear whether chemotherapy-associated processes may also be involved in the pathogenesis of these 'tumor-associated' ARDS cases. A recent case series from Kirch et al [5] reported 16 patients with non-seminomatous germ cell tumors and lung metastases who were admitted to the ICU for respiratory distress. In this patient cohort, 9 patients (56%) developed ARDS requiring mechanical ventilation within a median of 2.5 days only after the initiation of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only case reports or small retrospective single-center case series (e.g. from the 'Institut Gustave Roussy') have reported a 'tumor-associated' acute respiratory distress syndrome (ARDS) in patients with non-Boeck/Metzeler/Hausmann/Baumann/ Gallmeier/Parhofer/Stemmler seminomatous germ cell tumors and lung metastases [3][4][5]. Some authors also hypothesized a possible aggravation of acute pulmonary failure by chemotherapy-induced/-associated inflammatory processes and tumor lysis [5].…”

Section: Introductionmentioning

confidence: 99%

“…from the 'Institut Gustave Roussy') have reported a 'tumor-associated' acute respiratory distress syndrome (ARDS) in patients with non-Boeck/Metzeler/Hausmann/Baumann/ Gallmeier/Parhofer/Stemmler seminomatous germ cell tumors and lung metastases [3][4][5]. Some authors also hypothesized a possible aggravation of acute pulmonary failure by chemotherapy-induced/-associated inflammatory processes and tumor lysis [5]. Currently, no evidence-based prevention concepts or specific treatment options are defined for such a high-risk subgroup of patients who are at risk for developing ARDS after initiation of systemic cisplatin-based chemotherapy [2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cisplatin-Based Chemotherapy for Pulmonary Metastasized Germ Cell Tumors of the Testis – Be Aware of Acute Respiratory Distress Syndrome

Boeck

Metzeler²,

Hausmann³

et al. 2009

Oncol Res Treat

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Background: Cisplatin-based combination chemotherapy is regarded as standard of care for patients with advanced germ cell tumors. In patients with lung metastases and a high tumor load, an association between induction chemotherapy and the development of a ‘tumorassociated’ acute respiratory distress syndrome (ARDS) has been hypothesized. Case Report: We report the clinical course of a 19-year-old patient who rapidly developed fatal ARDS during the first cycle of chemotherapy using the PEI regimen (cisplatin, etoposide and ifosfamide) for a metastasized (lung, liver, lymph nodes) germ cell tumor of the testis. Conclusion: Further clinical research in order to better define risk factors for developing ARDS in this patient population as well as novel strategies for the prevention and treatment of ARDS in those patients are necessary.

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Acute respiratory distress syndrome after chemotherapy for lung metastases from non-seminomatous germ-cell tumors

Cited by 26 publications

References 25 publications

A case of metastatic testicular cancer complicated by pulmonary hemorrhage due to choriocarcinoma syndrome

A case of metastatic testicular cancer complicated by pulmonary hemorrhage due to choriocarcinoma syndrome

Severe acute tumor lysis syndrome in patients with germ-cell tumors

Cisplatin-Based Chemotherapy for Pulmonary Metastasized Germ Cell Tumors of the Testis – Be Aware of Acute Respiratory Distress Syndrome

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