Azacitidine-associated Acute Interstitial Pneumonitis

Abstract

Azacitidine is the first-line therapeutic option for myelodysplastic syndrome (MDS). This report describes a case of MDS in a patient who developed fatal acute interstitial pneumonitis (AIP) after the first seven-day course of intravenous azacitidine (75 mg/m 2 /day) treatment. A review of previous and present studies of azacitidine-associated AIP suggests that azacitidine may cause life-threatening AIP during or after the first seven-day course of treatment, with pyrexia commonly preceding AIP. Although the non-hematologic adverse events associated with azacitidine are generally relatively mild, further accumulation of evidence may help to make an earlier diagnosis of azacitidine-associated AIP.

Rare Respiratory and Neurologic Adverse Reactions to Azacitidine in the Treatment of Myelodysplastic Syndrome of Patients Treated at the Ottawa Hospital

“…All cases of azacitidine-induced pulmonary toxicity have been described as pneumonitis and eosinophilic pneumonia which are characterized by cough, lung infiltrates, and the presence of eosinophils in the alveolar spaces and pulmonary interstitium [12][13][14][15][16]. Chest CT in all cases showed bilateral airspace disease, nodular opacities, bilateral patchy infiltrates, and en-largement of mediastinal and hilar lymph nodes.…”

Azacitidine-Induced Interstitial Pneumonitis

“…6,8,9 However, the observed clinical consequences were sufficiently serious to consider this adverse event as clinically significant. Our case report contributes to input these toxicity data.…”

“…5 Although azacitidine is well tolerated, rare clinical data from literature report interstitial lung disease secondary to azacitidine administration, which should therefore be considered as a serious potential adverse event. [6][7][8][9] We, herein, report a case of an 86-year-old white woman with AML and azacitidine-induced interstitial pneumonitis.…”

Partial Trisomy 1q21-qter and Partial Monosomy 7q21-qter Due to a Derivative Chromosome 7 in Myelodysplastic Syndrome Associated with Squamous Cell Carcinoma: Case Report

“…According to the literature, five previously reported cases of ILD in association with hypomethylating agents for treatment of MDS: four were reported in connection with azacitidine [25] [26] [27] [28] and one with decitabine [29].…”