Temozolomide-Associated Bronchiolitis Obliterans Organizing Pneumonia Successfully Treated with High-Dose Corticosteroid

Kim, Tae-Ok; Oh, In Jae; Kang, Hyun‐Wook; Chi, Su-Young; Ban, Hee Jung; Kwon, Yong Soo; Kim, Kyu‐Sik; Kim, Yu-Il; Lim, Sung‐Chul; Kim, Young‐Chul

doi:10.3346/jkms.2012.27.4.450

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…Among the combination agents used in the pneumonitis group, the most common agent was octreotide, which is not recognized as a major pulmonary-toxic agent. Temozolomide, which was given in 3 patients in the pneumonitis group, is known to cause pneumonitis 23-26 , and it is not possible to exclude its added effect. However, no significant association was noted between pneumonitis and temozolomide use among 60 patients treated with combination therapy (p=0.73).…”

Section: Discussionmentioning

confidence: 99%

Drug-related pneumonitis during mammalian target of rapamycin inhibitor therapy in patients with neuroendocrine tumors: a radiographic pattern-based approach

Nishino

Brais

Brooks

et al. 2016

European Journal of Cancer

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Purpose Investigate the incidence of drug-related pneumonitis during mTOR inhibitor therapy in patients with neuroendocrine tumors (NET), and characterize radiographic patterns of pneumonitis. Methods Sixty-six patients (39 males, 27 females, age: 22-79 years) with advanced NET treated with mTOR inhibitor, everolimus, were retrospectively studied. Chest CT scans during therapy were reviewed for abnormalities suspicious for drug-related pneumonitis by an independent review of two radiologists. Extent, distributions, and specific findings were evaluated in cases positive for pneumonitis. Radiographic patterns of pneumonitis were classified using ATS/ERS classification of interstitial pneumonia. Results Drug-related pneumonitis was radiographically detected in 14 patients (21%). Time from the initiation of therapy to pneumonitis was within 6 months of therapy in 10 patients (71%), while it ranged from 1.0 to 27.7 months. Pneumonitis was more common in patients who had never smoked (p=0.03). Lower lungs were more extensively involved than upper and middle lungs. Peripheral and lower distribution was most common (n=8), followed by peripheral and multifocal distribution (n=3). Ground glass and reticular opacities were present in all cases, with consolidation in 8 cases. The radiographic pattern of pneumonitis was classified as cryptogenic organizing pneumonia (COP) pattern in 8, non-specific interstitial pneumonia (NSIP) pattern in 5, and hypersensitivity pneumonitis (HP) pattern in one patient. Conclusion Drug-related pneumonitis was noted in 21% of the advanced NET patients treated with everolimus. Radiographic pattern of pneumonitis was most commonly COP pattern, followed by NSIP pattern.

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Section: Discussionmentioning

confidence: 99%

Drug-related pneumonitis during mammalian target of rapamycin inhibitor therapy in patients with neuroendocrine tumors: a radiographic pattern-based approach

Nishino

Brais

Brooks

et al. 2016

European Journal of Cancer

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“…The dose was gradually reduced after 3 months, with the overall course duration varying between 6 and 27 months, or longer. A previous study used steroid therapy, for a period ranging between 1 and 60 months, in children receiving different BO treatments, including bronchodilators, azithromycin and oxygen therapy (28). Among these patients, >80% exhibited rapid improvement in disease symptoms when medicated using steroids.…”

Section: Diagnostic -------------------------------------------------mentioning

confidence: 99%

Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment

Wang

Liu

Wang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to outline any predisposing factors and clinical and radiological features of post-infectious bronchiolitis obliterans (PIBO) in pediatric patients, and to determine the effect of long-term azithromycin treatment on these factors. In total, 16 cases of children with PIBO were retrospectively reviewed. Adenovirus and Mycoplasma pneumoniae were the most common etiological agents (12/16) in the children with PIBO. The patients presented with persistent dyspnea, a chronic cough, sputum production and wheezing following the initial lung infection. Chest X-rays indicated pulmonary overinflation and patchy ground-glass opacity. In addition, high-resolution computed tomography (HRCT) scans revealed patchy ground-glass opacity, bronchiectasis, bronchial wall thickening and mosaic perfusion in all 16 cases. A unilateral hyperlucent lung was observed in two cases. All the patients underwent treatment with low-dose azithromycin and prednisone. Follow-up examinations of the 16 cases, varying in duration between 7 and 31 months, showed that the disease condition had improved in 10 cases. However, no significant improvements were identified from the HRCT scans or were observed in the patient condition in the additional six cases. The diagnosis of BO is primarily based on a typical clinical presentation and HRCT observations. Therefore, a typical clinical history and patchy ground-glass opacity features on HRCT scans are screening indices that predict BO development. Steroids are the cornerstone of BO treatment; however, long-term azithromycin treatment can improve the condition of the patients. In summary, PIBO is a disease with a high morbidity rate and should be treated by a multidisciplinary team. Patients should receive follow-up examination for an extended period. Patchy ground-glass opacity features on HRCT scans indicate that clinical suspicion of BO is necessary in children with persistent and severe wheezing.

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“…Then 122 articles were selected for reading. 2 , 4 , 5 , 6 , 7 , 8 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

Section: Resultsunclassified

Systematic Review of Systemic Corticosteroids for Treatment of Organizing Pneumonia

Cendon¹,

Codern²,

Rosa³

et al. 2022

Open Respiratory Archives

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Temozolomide-Associated Bronchiolitis Obliterans Organizing Pneumonia Successfully Treated with High-Dose Corticosteroid

Cited by 8 publications

References 12 publications

Drug-related pneumonitis during mammalian target of rapamycin inhibitor therapy in patients with neuroendocrine tumors: a radiographic pattern-based approach

Drug-related pneumonitis during mammalian target of rapamycin inhibitor therapy in patients with neuroendocrine tumors: a radiographic pattern-based approach

Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment

Systematic Review of Systemic Corticosteroids for Treatment of Organizing Pneumonia

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