Pomalidomide-Induced Pulmonary Toxicity in Multiple Myeloma

Pomalidomide-induced lung injury: A case report

“…The 7 case reports [16][17][18][19][20][21] and the present case report of pomalidomide-induced lung injury are summarized in Table 1. These cases present several similarities.…”

“…Geyer, 2011 [16] -abrupt dyspnea -O 2 desaturation 480 d patchy ground glass opacities mid to upper lungs with consolidative characteristics considered as normal antibiotics + Pomalidomide discontinuation -rapid improvement -relapse at reintroduction Geyer, 2011 [16] -abrupt dyspnea -fever -O 2 desaturation 120 d patchy ground glass opacities mid to upper lungs with diffuse central lobular fluffy infiltrates 43% macrophages 5% lymphocytes 45% eosinophils Pomalidomide discontinuation + steroid treatment -rapid improvement -reintroduction without recurrence Tello, 2013 [17] -respiratory failure -dyspnea -fever 7 d diffuse alveolar opacities alveolar hemorrhage Pomalidomide discontinuation + steroid treatment -rapid improvement -relapse at reintroduction Modi, 2015 [18] -progressive dyspnea -cough -fever -O2 desaturation 8 mo ground glass opacities upper lungs not realized antibiotics + Pomalidomide discontinuation + steroid treatment -progressive improvement -relapse at reintroduction Gajic, 2018 [19] -progressive dyspnea -O2 desaturation 22 mo ground glass opacities mid to upper lungs, fibrosis 30% lymphocytes Pomalidomide discontinuation + steroid treatment -progressive resolution -fibrosis lesions Kumar, 2018 [20] -respiratory failure -cough -fever unknown consolidation of both lungs, pleural effusion Not realized antibiotics + antifungals + Pomalidomide discontinuation rapid resolution Icard, 2021 [21] -fever -lethargy…”

A Review of Interstitial Pneumonitis Caused by Elotuzumab Through Case Discussions and Academic Writings

“…The histological and radiological patterns vary, including organizing/hypersensitivity/(non-specific) interstitial pneumonitis, acute respiratory distress syndrome, and diffuse alveolar haemorrhage. Four prior acute lung toxicity reports exist related to pomalidomide [12][13][14]. It usually takes 8 -120 days from initiation of treatment to onset of symptoms.…”

“…It usually takes 8 -120 days from initiation of treatment to onset of symptoms. Symptoms of immunomodulatory drugs lung toxicity include cough, dyspnea, fever, and hypoxia; ground-glass opacities being the most common radiological findings [12]. Significant take-away from the first case is that despite his long history of treatment with lenalidomide, interstitial pneumonitis developed acutely after elotuzumab was added to the combined therapy.…”

“…Pulmonary toxicity associated with elotuzumab (combined with lenalidomide/pomalidomide and dexamethasone) was barely described in Phase 1-3 clinical trials [5][6][7]. Only one case report of elotuzumab induced interstitial lung disease exists [8], with a few cases reports on lenalidomide and pomalidomide induced interstitial lung disease [9][10][11][12][13][14]. This article covers two cases of acute hypoxic respiratory failure upon administration of elotuzumab, and both treated successfully with corticosteroids.…”