Chemotherapy-Induced Lung Disease

Abstract

Chemotherapy-induced lung disease (CILD) can be caused by multiple agents. The diagnosis should be considered in any patient who develops pulmonary symptoms during or after treatment with chemotherapy. It is a diagnosis made by exclusion of other etiologies, especially recurrent tumor or infection. The most common clinical presentations are interstitial pneumonitis/fibrosis, hypersensitivity pneumonitis, and capillary leak syndrome. The clinical characteristics of bleomycin, mitomycin, carmustine, and methotrexate have been well characterized, while newer syndromes caused by gemcitabine, paclitaxel, docetaxel, and fludarabine are being recognized. The clinical approach to patients with suspected CILD must be tailored to the individual patient according to their underlying disease and treatment history, with special attention to the nature of their immunocompromise. Diagnostic procedures are performed to the extent needed to exclude other likely diagnoses. For patients with limited pulmonary reserve, empiric therapy may be a reasonable option.

COVID-19 in Cancer and Non-cancer Patients

“…Based on our observations, the rate of ICU admission was similar, however, Ca + patients required more mechanical ventilation. This may be due to the adverse effects of prior chemotherapy or radiotherapy on the respiratory capacity of patients (16,17). In a retrospective analysis, Miyashita et al (3) found that a history of cancer significantly increased the intubation rate in patients aged 66 -80 years [relative risk (RR):1.76, 95% CI 1.15 -2.70].…”

Cyclophosphamide‐induced acute respiratory distress syndrome

“…Presentation is characterized by dyspnoea, non‐productive cough and often fever 2 . No radiographic or pathologic finding is pathognomonic for chemotherapy‐induced lung disease and therefore the diagnosis is based on the temporal relationship, type of clinical presentation and the exclusion of infection or progression of the neoplastic process by invasive procedures 35 . Flow cytometry of BAL specimen has been reported to differentiate CPA toxicity from lymphoma progression 36 .…”

Pulmonary lesions due to drug therapy of Hodgkin's lymphoma

“…Самый серьез ный побочный эффект блеомицина заключается в его токсичности относительно легких. С примене нием блеомицина связано несколько отчетливых ле гочных синдромов, таких как облитерирующий бронхиолит с организующей пневмонией [9], эози нофильная гиперчувствительность [10] и, чаще всего, интерстициальный блеомициновый пульмонит (БП), способный завершиться фиброзом легких [11]. Ле карственный пульмонит встречается с частотой до 46 % случаев применения блеомицина, в зависимо сти от критериев установления его диагноза [12], а смертность от БП может достигать 3 % от всех слу чаев применения блеомицина [13].…”