Bleomycin-induced Pneumonitis in a Child Treated With Nintedanib: Report of the First Case in a Childhood

J Pediatr Hematol Oncol. 2022 Mar 1;44(2):e500-e502. doi: 10.1097/MPH.0000000000002266.

Abstract

Pulmonary fibrosis caused by bleomycin-induced pneumonia (BIP) is the most important side effect limiting the use of bleomycin and is mainly treated with corticosteroids. However, 1% to 4% of patients do not respond to corticosteroid therapy. Idiopathic pulmonary fibrosis and BIP develop by similar pathophysiological mechanisms. Nintedanib is a tyrosine kinase inhibitor used successfully in the treatment of idiopathic pulmonary fibrosis and there is no information about its use in BIP treatment. Here, we would like to present a 13-year-old boy with Hodgkin lymphoma who developed BIP after 2 cycles of ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) and 4 cycles of BAECOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), whose respiratory failure impaired despite corticosteroid therapy, but was successfully treated with nintedanib.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bleomycin
  • Child
  • Dacarbazine
  • Doxorubicin
  • Etoposide
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / pathology
  • Humans
  • Idiopathic Pulmonary Fibrosis* / drug therapy
  • Indoles
  • Male
  • Pneumonia* / chemically induced
  • Pneumonia* / drug therapy
  • Prednisone / therapeutic use
  • Vinblastine
  • Vincristine

Substances

  • Indoles
  • Bleomycin
  • Vincristine
  • Vinblastine
  • Etoposide
  • Dacarbazine
  • Doxorubicin
  • nintedanib
  • Prednisone