Finally, chemotherapeutic agents are often given in combinations, complicating the assessment of which drug is responsible. Onset may be abrupt, occurring several hours after administration of the vinca alkaloid, and clinical manifestations may be severe.Interstitial pneumonitis with pulmonary fibrosis typically occurs 3-4 months after mitomycin treatment and appears to be dose-related; a cumulative dose of 20 mg/mPulmonary hypertension related to pulmonary veno-occlusive disease, typically occurring 4 months after treatment.Microangiopathic hemolytic anemia and renal failure, with or without pulmonary hemorrhage, have been reported; the syndrome may occur within months after initiation of mitomycin or up to several months after cessation of treatment.Like bleomycin and mitomycin, Actinomycin D may cause pulmonary toxicity in the form of acute or subacute interstitial lung disease. Cyclophosphamide, also called Cytoxan, is classified as a cytotoxic agent, because it has a toxic effect on many types of cells (good cells as well as bad). If you wish to read unlimited content, please log in or register below. 0000020854 00000 n
A rapid course may mimic noncardiogenic pulmonary edema, while a more subacute course presents insidiously over weeks or months. The major classes of chemotherapeutic agents and their toxicities are discussed below.Pulmonary Toxicity Associated with Cytotoxic AntibioticsPulmonary toxicity due to bleomycin is one of the most common, severe and extensively studied chemotherapy complications. 0000008757 00000 n
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BAL fluid analysis usually demonstrates a nonspecific elevation in cell counts in patients with drug toxicity, although an elevation in eosinophils may suggest hypersensitivity reactions.Surgical lung biopsy, including video-assisted thoracoscopic surgery (VATS) and open thoracotomy, are more invasive procedures that allow for larger portions of lung tissue to be sampled compared to transbronchial biopsies. Similarly, amiodarone lung toxicity is more common in males, but this may be related to the fact that amiodarone is used more often in males, rather than a sex-specific predilection. 0000012722 00000 n
Long-term follow-up studies on the clinical course are sparse. Gemcitabine is a radiosensitizer, and the possibility of severe radiation-associated pneumonitis should be considered with prior, concurrent, or post-treatment thoracic radiation.
The role of screening and monitoring for bleomycin pulmonary toxicity. Because these symptoms are similar to other conditions that can be experienced by cancer patients such as pneumonia or the spread of malignant cells into the lungs, specialists must rule these out before assuming a diagnosis of treatment-related pulmonary toxicity.
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ATRA induces the maturation of leukemic cells to normal neutrophils.
This may be due to chemotherapy drugs, or other medications you may be taking to control your disease. The usual symptom is progressive dyspnea. The reactions usually occur during or within a few hours of termination of the infusion. Updated 09/28/15.Pal, S. Bleomycin Induced Lung Injury. 0000016361 00000 n
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Rare but life threatening pulmonary toxicities have been reported including organizing pneumonia, interstitial pneumonitis, and ARDS.
Pulmonary toxicity can range from inflammation of the lining of the lungs to permanent scarring of the lung tissues. 0000022220 00000 n
Inflammatory response of the lung tissues following exposure to chemotherapy or radiation 0000017295 00000 n