Development of fatal bortezomib induced acute lung injury despite concurrent therapy with high-dose dexamethasone

Chew, Edward; Filshie, Robin; Wei, Andrew H.

doi:10.1080/10428190600988010

Cited by 17 publications

(13 citation statements)

References 3 publications

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“…For our patient, prednisolone was being tapered due to hypercalcemia at the time of onset of BIP. Therefore, low-dose steroids could not prevent the development of BIP, similar to a previous report (5).…”

supporting

confidence: 64%

Bortezomib-induced Pneumonitis During Bortezomib Retreatment in Multiple Myeloma

Yamaguchi

Sasaki

Itoh

2012

Japanese Journal of Clinical Oncology

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Bortezomib is a proteasome inhibitor and is active against multiple myeloma. Most toxicities associated with bortezomib are mild to moderate and manageable; however, bortezomibinduced pneumonitis has been reported in some multiple myeloma cases. Bortezomibinduced pneumonitis was reported to occur relatively soon after the first administration of bortezomib. A 64-year-old Japanese man with multiple myeloma received low-dose dexamethasone followed by bortezomib monotherapy as the initial therapy. He had no pulmonary complications during bortezomib treatment. Thereafter, he was treated with highdose chemotherapy, followed by autologous peripheral blood stem cell transplantation. Ten months after autologous peripheral blood stem cell transplantation, his disease relapsed and he received bortezomib retreatment. On the fifth day after the second dose of weekly bortezomib, he complained of mild dyspnea, dry cough and fever. High-resolution computed tomography of the chest showed bilateral infiltrates with partial ground glass appearance in the lower lobes. The diagnosis of bortezomib-induced pneumonitis was made. His bortezomib-induced pneumonitis responded to steroid therapy and his respiratory symptoms disappeared. This is the first report in which bortezomib-induced pneumonitis occurred during bortezomib retreatment for relapsed multiple myeloma. Careful management is needed during bortezomib retreatment, even after the previous course of bortezomib was administered safely.

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supporting

confidence: 64%

Bortezomib-induced Pneumonitis During Bortezomib Retreatment in Multiple Myeloma

Yamaguchi

Sasaki

Itoh

2012

Japanese Journal of Clinical Oncology

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“…Our case of toxic death might not be associated with bortezomib, because the radiologic findings of our patient were different from those of bortezomib-induced lung disease and showed typical upper lobar pneumonia [20, 21]. While peripheral neuropathy may be the main adverse effect of bortezomib, there was no de novo case of peripheral neuropathy in this study.…”

Section: Discussionmentioning

confidence: 63%

Bortezomib and melphalan as a conditioning regimen for autologous stem cell transplantation in multiple myeloma

et al. 2010

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BackgroundHigh-dose melphalan (200 mg/m2) with autologous stem cell transplantation (ASCT) is the standard treatment for young patients with multiple myeloma (MM). However, the response rates after ASCT are often unsatisfactory. We performed a pilot study by using bortezomib-melphalan as conditioning regimen for ASCT in Korean patients with MM.MethodsThe conditioning regimen consisted of administration of intravenous infusion of bortezomib 1.0 mg/m2 on days -4 and -1 and melphalan 50 mg/m2 (day -4) and 150 mg/m2 (day -1). In this study, we enrolled 6 newly diagnosed patients and 2 patients with relapse.ResultsThe disease status of the 6 newly diagnosed patients at ASCT was as follows: 1 complete remission (CR), 1 very good partial remission (VGPR), and 4 partial remissions (PRs). The disease status of the 2 relapsed patients at ASCT was PR. All patients except 1 showed adequate hematologic recovery after ASCT. The median time for the absolute neutrophil counts to increase over 500/mm3 was 13 days (range, 10-19 days). Six patients with VGPR or PR at the time of transplantation showed an improvement in response to CR after ASCT. The patients were followed up without any maintenance treatment after ASCT except 1 patient who died during ASCT. During the follow-up period, CR was maintained in 3 newly diagnosed patients, but the other 4 patients, including 2 newly diagnosed patients, relapsed.ConclusionConditioning regimen consisting of bortezomib and melphalan may be effective for ASCT in MM; however, the feasibility of this regimen should be further evaluated in large study populations.

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“…[16][17][18][19] In 31 patients on this TACL T2005-003 protocol (phase 1 and phase 2), pleural effusions, hypoxia, and/or pneumonitis were associated with bacterial infection. Thus, severe lung injury was not found in this population, possibly because of the protective effect of dexamethasone that is given in parallel to bortezomib, or because of the young age of the subjects.…”

Section: Discussionmentioning

confidence: 99%

Bortezomib with chemotherapy is highly active in advanced B-precursor acute lymphoblastic leukemia: Therapeutic Advances in Childhood Leukemia & Lymphoma (TACL) Study

Messinger

Gaynon

Sposto

et al. 2012

Blood

189

144

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Therapy of relapsed pediatric acute lymphoblastic leukemia (ALL) is hampered by low remission rates and high toxicity, especially in second and subsequent relapses. Our phase 1 study, T2005-003, showed that the combination of bortezomib with vincristine, dexamethasone, pegylated asparaginase, and doxorubicin had acceptable toxicity. We report the phase 2 expansion of this combination in patients with relapsed ALL who failed 2-3 previous regimens. Twenty-two patients with relapsed ALL were treated with bortezomib combined with this regimen; their ages ranged from 1 to 22 years, and they had either B-precursor ALL (n ‫؍‬ 20) or T-cell ALL (n ‫؍‬ 2). Grade 3 peripheral neuropathy developed in 2 (9%) patients. After 3 patients died from bacterial infections, treatment with vancomycin, levofloxacin, and voriconazole prophylaxis resulted in no further infectious mortality in the last 6 patients. Fourteen patients achieved complete remission (CR), and 2 achieved CR without platelet recovery, for an overall 73% response rate, meeting predefined criteria allowing for early closure. B-precursor patients faired best,

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Development of fatal bortezomib induced acute lung injury despite concurrent therapy with high-dose dexamethasone

Cited by 17 publications

References 3 publications

Bortezomib-induced Pneumonitis During Bortezomib Retreatment in Multiple Myeloma

Bortezomib-induced Pneumonitis During Bortezomib Retreatment in Multiple Myeloma

Bortezomib and melphalan as a conditioning regimen for autologous stem cell transplantation in multiple myeloma

Bortezomib with chemotherapy is highly active in advanced B-precursor acute lymphoblastic leukemia: Therapeutic Advances in Childhood Leukemia & Lymphoma (TACL) Study

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