RARE PULMONARY TOXICITY DUE TO GEMCITABINE: BOOP

Yıl 2021, , 721 - 725, 31.12.2021

Pınar Çelik , Yavuz Havlucu , Fikret Kurhan , Talha Muezzinoglu , Tuğba Göktalay , Ayşın Şakar Coşkun , Arzu Yorgancıoğlu

https://doi.org/10.34087/cbusbed.877034

Öz

Gemcitabine is a primidine antimetabolite, a well tolerated chemotheropathic used in non-small cell lung carcinoma, pancreas, breast, urogenital malignancies. The most important dose-limiting toxicity is myelosuppression. Pulmonary toxicities due to gemcitabine use are bronchospasm, Acute Respiratory Distress Syndrome (ARDS), pleural effusion and interstitial pneumonia. Complaints of shortness of breath, fever and cough occurred in a male patient who received 5 cycles of cisplatin-gemcitabine chemotherapy for bladder carcinoma. There was no response to antibiotic treatment in the patient, who had mainly peripheral, patchy consolidation areas on thorax computed tomography. In the patient whose other causes of dyspnea were excluded, bronchiolitis obliterans organizing pneumonia (BOOP) was considered clinically and radiologically, and significant improvement was achieved with corticosteroid therapy. It should be kept in mind that BOOP may develop as pulmonary toxicity due to gemcitabine use, as delay in diagnosis and treatment may lead to fatal results.

Anahtar Kelimeler

Gemcitabine, Pulmonary toxicity, BOOP

GEMSİTABİNE BAĞLI GELİŞEN NADİR PULMONER TOKSİSİTE: BOOP

Öz

Gemsitabin bir primidin antimetabolitidir, küçük hücreli dışı akciğer karsinomu, pankreas, meme, ürogenital malignitelerde artan sıklıkta kullanılan, iyi tolere edilen bir kemoteropatiktir. En önemli doz kısıtlayıcı toksisitesi myelosupresyondur. Gemsitabin kullanımına bağlı gelişen pulmoner toksisiteler bronkospazm, Acute Respiratory Distress Syndrome (ARDS), plevral effüzyon ve interstisyel pnömonidir. Mesane karsinomu nedeniyle 5 kür sisplatin-gemsitabin kemoterapisi alan erkek hastada nefes darlığı, ateş ve öksürük yakınmaları ortaya çıkması, toraks bilgisayarlı tomografisinde (BT) periferik ağırlıklı, yamalı tarzda konsolidasyon alanları görülmesi, antibiyotik tedavisiyle yanıt alınamaması, olası dispne nedenleri dışlanması sonucunda klinik ve radyolojik olarak bronşiolitis obliterans organize pnömonisi (BOOP) düşünülmüş ve kortikosteroid tedavisi ile belirgin düzelme sağlanmıştır. Tanı ve tedavide gecikme fatal sonuçlara yol açabileceği için gemsitabin kullanımına bağlı pulmoner toksisite olarak BOOP gelişebileceği de akılda tutulmalıdır

Anahtar Kelimeler

Gemsitabine, Pulmoner Toksisite, BOOP

Kaynakça

• Ko, E, Lee, S, Goodman, A, Gemcitabine pulmonary toxicity in ovarian cancer, Oncologist, 2008, 13(7), 807-11.
• Shaib, W, Lansigan, F, Cornfeld, D, Syrigos, K, Saif, M.W. Gemcitabine-induced pulmonary toxicity during adjuvant therapy in a patient with pancreatic cancer, Journal of the pancreas, 2008, 9(6), 708-14.
• Baig, J, Shokouh-Amiri, M, Chan, J, Chowdhery, R, Danthurthy, S, Venepalli, N.K, The Spectrum of Pulmonary Toxicity in Pancreatic Cancer Patients Receiving Gemcitabine Combination Chemotherapy, Case reports in oncology, 2019, 12(2), 506-512.
• Gupta N, Ahmed I, Steinberg, H, et al., Gemsitabine- induced pulmonary toxicity: Case report and review of the literatüre, American journal of clinical oncology, 2002, 25, 96-100.
• Pavlakis, N, Bell, D.R, Millward, M.J et al., Fatal pulmonary toxicity resulting from treatment with gemcitabine, Cancer, 1997, 80, 286-291.
• Hiraya, D, Kagohashi, K, Sakamoto, N, Kondo, T, Satoh, H, Gemcitabine-induced pulmonary toxicity in a patient with pancreatic cancer, Journal of the pancreas, 2010, 11(2), 186-8.
• Kawsar, H.I, Spiro, T.P, Cocco, A, Daw, H.A, BOOP as a rare complication of gemcitabine therapy, BMJ Case Reports, 2011, 20, 1-5.
• von der Maase, H, Hansen, S.W, Roberts, J.T, et al., Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study, Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2000, 18, 3068-3077.
• Roychowdhury, D.F, Cassidy, C.A, Peterson, P, Arning, M.A report on serious pulmonary toxicity associated with gemcitabine-based therapy, Investigational new drugs, 2002, 20(3), 311-5.
• Vahid, B, Marik, P.E, Pulmonary complications of novel antineoplastic agents for solid tumors, Chest, 2008, 133(2), 528-38.
• Cobo Dols, M, Gil Calle, S, Ales Diaz, I et al., Bronchiolitis obliterans organizing pneumonia simulating progression in bronchioloalveolar carcinoma. Clinical and translational oncology 2006, 8, 133-5.
• Aguiar Bujanda, D, Guiar Morales, J, Bohn Sarmiento, U, Bronchiolitis obliterans organizing pneumonia induced by chemotherapy, Archivos de bronconeumología, 2004, 40, 290.
• Epler, G.R, Bronchiolitis obliterans organizing pneumonia, Archives of internal medicine, 2001, 161, 158-64.
• Muller, N.L, Guerry-Force, M.L, Staples, C.A et al., Differential diagnosis of bronchiolitis obliterans organizing pneumonia and usual interstial pneumonia: clinical, functional and radiologic findings, Radiology, 1987, 162, 151-56.