Pulmonary cytotoxicity induced by bleomycin and methotrexate
https://doi.org/10.20862/0042-4676-2015-0-3-46-51
Abstract
Early detection of drug-induced pulmonary parenchymal injuries is often hampered by nonspecific clinical and X-ray manifestations. The diagnosis is usually based on a history of drug use, clinical and X-ray presentation, and exclusion of other causes of lung tissue injury.
Chemical preparations most commonly cause pathological pulmonary changes. Overall, about 10% of all patients receiving chemotherapy develop pathological changes in the lung parenchyma. The main chemical preparations causing lung injury are bleomycin, methotrexate, carmustine, busulfan, and cyclophosphamide.
Out of all examination techniques, computed tomography is most sensitive in determining the presence, specific features, and trends in the development of drug-induced pulmonary parenchymal
disease.
The paper gives the data available in the literature and 2 clinical observations of pulmonary parenchymal disease induced by bleomycin and methotrexate.
About the Authors
Zh, V, Sheykh
S.P. Botkin City Clinical Hospital, Moscow City Health Department
Russian Federation
MD, PhD, DSc, Chief of Computed Tomography Department
Russian Federation
MD, PhD, DSc, Chief of Computed Tomography Department
A. O. Krutskevich
A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical-Biological Agency of Russia
Russian Federation
Resident Physician
Russian Federation
Resident Physician
N. S. Drebushevskiy
A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical-Biological Agency of Russia
Russian Federation
MD, PhD, Chief of Department of Radiation and Radioisotope Diagnosis
Russian Federation
MD, PhD, Chief of Department of Radiation and Radioisotope Diagnosis
S. N. Shvayko
S.P. Botkin City Clinical Hospital, Moscow City Health Department
Russian Federation
MD, PhD, Chief of Departmet of Pulmonology
Russian Federation
MD, PhD, Chief of Departmet of Pulmonology
A. P. Dunaev
A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical-Biological Agency of Russia
Russian Federation
MD, PhD, Radiologist of Department of Radiation and Radioisotope Diagnosis
Russian Federation
MD, PhD, Radiologist of Department of Radiation and Radioisotope Diagnosis
V. G. Alekseev
S.P. Botkin City Clinical Hospital, Moscow City Health Department
Russian Federation
MD, PhD, DSc, Professor, Deputy Physician-in-Chief for Therapy
Russian Federation
MD, PhD, DSc, Professor, Deputy Physician-in-Chief for Therapy
References
1. Fraser R.S., Muller N.L. et al. Diagnosis of diseases of the chest. 4th ed. Philadelphia: Saunders; 1999: 2537–83.
2. Blum R.H., Carter S.K. et al. A clinical review of bleomycin – a new antineoplastic agent. Cancer. 1973; 31: 903–13.
3. Bauer K., Skarin A., Balikian J. Pulmonary complications associated with combination chemotherapy regimens containing bleomycin. Abstract presented at annual meeting of the American Society of Clinical Oncology. Washington, DC. March 1981.
4. Baliian J.P., Jochelson M.S., Bauer K.A. et al. Pulmonary complications of chemotherapy regimens containing bleomycin. AJR. 1982; 139: 455–61.
5. Holeye P.Y., Luna M.A., MacKay B. et al. Bleomycin hypersensitivity pneumonitis. Ann. Intern. Med. 1978; 88: 47–9.
6. Rudders R.A., Hensley G.T. Bleomycin pulmonary toxicity. Chest. 1973; 63: 626–8.
7. Lacovino J.R., Leitner J., Abbas A.K. et al. Fatal pulmonary reaction from low doses of bleomycin. JAMA. 1976; 235: 1253–5.
8. Bozyk P.D., Moore B.B. Prostaglandin E2 and the pathogenesis of pulmonary fibrosis. Am. J. Respir. Cell. Mol. Biol. 2011; 45: 445–52.
9. Bonadonna G., De Lena M., Monfardini S. et al. Clinical trials with bleomycin in lymphomas and in solid tunors. Eur. J. Cancer. 1972; 8: 205–15.
10. ATS American Thoracic Society. Idiopathic Pulmonary Fibrosis: Diagnosis and Treatment International Consensus Statement. Am. J. Respir. Crit. Care Med. 2000; 161: 646–64.
11. American Thoracic Society/European Respiratory Society American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am. J. Respir. Crit. Care Med. 2002; 165: 277–304.
12. American Thoracic Society Idiopathic pulmonary fibrosis: diagnosis and treatment International consensus statement American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am. J. Respir. Crit. Care Med. 2000; 161: 646–64.
13. De Lena M., Guzzon А., Monfardini S. et al. Radiologic and histopathologic studies on pulmonary toxicity induced by treatment with bleomycin (NSC-125066). Cancer Chemother. Rep. 1972; 131: 299–304.
14. Rosenow E.C. Drug-induced pulmonary disease. Dis. Mon. 1994; 40: 253–10.
15. Padley S.P., Adler B., Hansell D.M. et al. High-resolution computed tomography of drug-induced lung disease. Clin. Radiol. 1992; 46: 232–6.
16. Du Bois R.M. Strategies for treating idiopathic pulmonary fibrosis. Nat. Rev. Drug. Discov. 2010; 9: 129–40.
17. Kremer J.M., Alarcуn G.S., Weinblatt M.E. et al. Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis: a multicenter study with literature review. Arthritis Rheum. 1997; 40: 1829.
18. Cooper J.A. Jr, White D.A., Matthay R.A. Drug-induced pulmonary disease. Part 1: Cytotoxic drugs. Am. Rev. Respir. Dis. 1986; 133: 321.
19. Rossi S.E., Erasmus J.J., McAdams H.P. et al. Pulmonary drug toxicity: radiologic and pathologic manifestations. Radiographics. 2000; 20 (5): 1245–59.
20. Imokawa S., Colby T.V., Leslie K.O., Helmers R.A. Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients. Eur. Respir. J. 2000; 15: 373–81.
21. Bernstein M.L., Sobel D.B., Wimmer R.S. Noncardiogenic pulmonary edema following injection of methotrexate into the cerebrospinal fluid. Cancer. 1982; 50: 866–8.
22. Sostman H., Matthay R., Putman C., Smith G. Methotrexateinduced pneumonitis. Medicine (Baltimore). 1976; 55: 371–88.
23. Kinder A.J., Hassell A.B., Brand J., Brownfield A., Grove M., Shadforth M.F. The treatment of inflammatory arthritis with methotrexate in clinical practice: treatment duration and incidence of adverse drug reactions. Rheumatology. 2005; 44: 61–6.
24. Arakawa H., Yamasaki M., Kurihara Y. et al. Methotrexate-induced pulmonary injury: serial CT findings. J. Thorac. Imag. 2003; 18 (4): 231–6.
25. Padley S.P.G., Adler B., Hansell D.M., Muller N.L. High-resolution computed tomography of drug-induced lung disease. Clin. Radiol. 1992; 46: 232–6.
26. Alarcon G.S., Koopman W.J., McCarty M.J. Nonperipheral accelerated nodulosis in a methotrexate-treated rheumatoid arthritis patient. Arthritis Rheum. 1993; 36: 132–3.
27. Cannon G.W., Ward J.R., Clеgg D.O., Samuelson C.O. Jr, Abbott T.M. Acute lung disease associated with low-dose pulse methotrexate therapy in patients with rheumatoid arthritis. Arthritis Rheum. 1983; 26: 1269–74. http://dx.doi.org/10.1002/art.1780261015
28. Carson C.W., Cannon G.W., Egger M.J., Ward J.R., Clegg D.O. Pulmonary disease during the treatment of rheumatoid arthritis with low dose pulse methotrexate. Semin. Arthritis Rheum. 1987; 16: 186–95.
29. Cannon G.W. Methotrexate pulmonary toxicity. Rheum. Dis. Clin. North. Am. 1997; 23 (4): 917–37.
Review
For citations:
Sheykh Zh.V., Krutskevich A.O., Drebushevskiy N.S., Shvayko S.N., Dunaev A.P., Alekseev V.G. Pulmonary cytotoxicity induced by bleomycin and methotrexate. Journal of radiology and nuclear medicine. 2015;(3):46-51. (In Russ.) https://doi.org/10.20862/0042-4676-2015-0-3-46-51
Views:
1628
Email this article 