Successful therapy with high-dose steroids and cyclosporine for the treatment of carmustine-mediated lung injury

Ann Hematol. 2002 Jun;81(6):347-9. doi: 10.1007/s00277-002-0464-5. Epub 2002 Jun 4.

Abstract

The treatment of the pulmonary toxicity induced by carmustine is nowadays based on the use of corticosteroids that generally lead to a rapid resolution of pneumonitis. On the contrary, no therapeutic alternatives are reported for those patients who do not respond to steroids. We describe a case of non-Hodgkin's lymphoma in a patient who developed a severe interstitial pneumonitis after an autologous transplantation including carmustine in the conditioning regimen. He was successfully treated with an association of steroids and cyclosporine A with a rapid improvement of symptoms and a complete resolution of pneumonitis. This is, to our knowledge, the first case of carmustine-induced pneumonitis, resistant to steroids alone, successfully treated with cyclosporine A. This suggests an immunoallergic mechanism in the pathogenesis of the damage, which can be reversed with prompt therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Alkylating / pharmacology*
  • Carmustine / pharmacology*
  • Cyclosporine / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoma, Non-Hodgkin / therapy
  • Methylprednisolone / administration & dosage*
  • Respiratory Distress Syndrome / chemically induced
  • Respiratory Distress Syndrome / drug therapy*

Substances

  • Antineoplastic Agents, Alkylating
  • Cyclosporine
  • Carmustine
  • Methylprednisolone