Pulmonary toxicity syndrome following CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) chemotherapy

Bone Marrow Transplant. 2001 Aug;28(4):399-403. doi: 10.1038/sj.bmt.1703147.

Abstract

We report on three patients with multiple myeloma who developed drug-induced pneumonitis 1-2(1/2) months following maintenance (post autologous transplantation) chemotherapy with CDEP (cyclophosphamide, dexamethasone, etoposide, cisplatin) and 6-20 months after exposure to carmustine (BCNU) 300 mg/m(2), used in combination with melphalan 140 mg/m(2), as pre-transplant conditioning regimen. All patients had either a proven (two) or suspected (one) fungal pneumonia and were treated with liposomal amphotericin B. Dyspnea, fever and cough were the prominent clinical symptoms, while air-space disease with ground glass appearance was seen radiographically. Histologic features typical for drug-induced lung injury were detected. All patients had a dramatic, clinical and radiographic response to a brief course of corticosteroids. Although CDEP-induced pneumonitis appears to be a rare complication, its early recognition and prompt treatment, as well as its possible association with preceding fungal infection may have important clinical implications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carmustine / administration & dosage
  • Carmustine / adverse effects
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Combined Modality Therapy / adverse effects
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Lung Diseases, Fungal / chemically induced*
  • Lung Diseases, Fungal / pathology
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / therapy
  • Pneumonia, Pneumocystis / chemically induced
  • Pneumonia, Pneumocystis / pathology
  • Syndrome
  • Transplantation Conditioning / adverse effects

Substances

  • Etoposide
  • Dexamethasone
  • Cyclophosphamide
  • Cisplatin
  • Carmustine