PDF(Pubmed)
Abstract：
UNASSIGNED: Brentuximab vedotin (BV) is an anti-CD30 antibody approved for various cancers, including refractory Hodgkin lymphoma (HL), anaplastic large-cell lymphoma (ALCL) among others. In general, BV has been found to be well-tolerated, with the most frequently reported side effects being peripheral neuropathy and neutropenia. BV-induced pneumonitis is extremely rare. To the best of our knowledge, this is the sixth reported instance of BV-induced lung toxicity.
UNASSIGNED: This case presents a female patient in her forties diagnosed with cutaneous T-cell lymphoma undergoing BV treatment. She developed acute hypoxic respiratory failure, ultimately, underwent a diagnostic evaluation including a computed tomography (CT) scan, which showed bilateral airspace consolidations and ground-glass opacities, suggestive of organizing pneumonia and diffuse alveolar damage. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy ruled out infection, and pulmonary lymphoma and confirmed the diagnosis of BV-induced pneumonitis. The patient had significant clinical improvement after stopping the offending agent, and starting steroids, with optimal clinical recovery at 8 weeks follow-up.
UNASSIGNED: Drug-related pneumonitis poses a significant concern in the management of cancer patients. Numerous chemotherapeutic agents, such as bleomycin, cyclophosphamide, methotrexate, thalidomide, and others, have been associated with pulmonary-related toxicities. These adverse effects primarily stem from direct toxicity or immunosuppression-related infections. Less commonly, immune-mediated injury may occur.
UNASSIGNED: Physicians must have a high index of suspicion for BV-induced pneumonitis, hence, early recognition with subsequent holding of the causative agent, initiation of immunosuppression with steroids, and occasionally steroid-sparing medications, prevent an otherwise fatal outcome.
UNASSIGNED: This case presents a female patient in her forties diagnosed with cutaneous T-cell lymphoma undergoing BV treatment. She developed acute hypoxic respiratory failure, ultimately, underwent a diagnostic evaluation including a computed tomography (CT) scan, which showed bilateral airspace consolidations and ground-glass opacities, suggestive of organizing pneumonia and diffuse alveolar damage. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy ruled out infection, and pulmonary lymphoma and confirmed the diagnosis of BV-induced pneumonitis. The patient had significant clinical improvement after stopping the offending agent, and starting steroids, with optimal clinical recovery at 8 weeks follow-up.
UNASSIGNED: Drug-related pneumonitis poses a significant concern in the management of cancer patients. Numerous chemotherapeutic agents, such as bleomycin, cyclophosphamide, methotrexate, thalidomide, and others, have been associated with pulmonary-related toxicities. These adverse effects primarily stem from direct toxicity or immunosuppression-related infections. Less commonly, immune-mediated injury may occur.
UNASSIGNED: Physicians must have a high index of suspicion for BV-induced pneumonitis, hence, early recognition with subsequent holding of the causative agent, initiation of immunosuppression with steroids, and occasionally steroid-sparing medications, prevent an otherwise fatal outcome.
摘要：
■Brentuximabvedotin（BV）是一种抗CD30抗体，已被批准用于各种癌症，包括难治性霍奇金淋巴瘤（HL），间变性大细胞淋巴瘤（ALCL）等。总的来说,已发现BV具有良好的耐受性，最常见的副作用是周围神经病变和中性粒细胞减少。BV诱导的肺炎极为罕见。据我们所知,这是第六例报道的BV诱导的肺毒性。
■该病例介绍了一名四十多岁的女性患者，诊断为皮肤T细胞淋巴瘤，正在接受BV治疗。她出现了急性低氧性呼吸衰竭,最终,接受了包括计算机断层扫描（CT）扫描在内的诊断评估，这显示了双边空域巩固和毛玻璃不透明，提示机化性肺炎和弥漫性肺泡损伤。支气管镜支气管肺泡灌洗和经支气管活检排除了感染，和肺淋巴瘤，并证实诊断为BV诱导的肺炎。患者在停用违例药物后有明显的临床改善,开始使用类固醇,在8周随访时具有最佳的临床恢复。
药物相关性肺炎在癌症患者的治疗中引起了极大的关注。众多的化疗药物，比如博来霉素,环磷酰胺,甲氨蝶呤,沙利度胺,和其他人,与肺部相关的毒性。这些不良反应主要源于直接毒性或免疫抑制相关感染。不太常见，可能发生免疫介导的损伤。
■医生必须高度怀疑BV引起的肺炎，因此，早期识别，随后持有病原体，用类固醇开始免疫抑制，偶尔还有保留类固醇的药物，防止其他致命的结果。
■该病例介绍了一名四十多岁的女性患者，诊断为皮肤T细胞淋巴瘤，正在接受BV治疗。她出现了急性低氧性呼吸衰竭,最终,接受了包括计算机断层扫描（CT）扫描在内的诊断评估，这显示了双边空域巩固和毛玻璃不透明，提示机化性肺炎和弥漫性肺泡损伤。支气管镜支气管肺泡灌洗和经支气管活检排除了感染，和肺淋巴瘤，并证实诊断为BV诱导的肺炎。患者在停用违例药物后有明显的临床改善,开始使用类固醇,在8周随访时具有最佳的临床恢复。
药物相关性肺炎在癌症患者的治疗中引起了极大的关注。众多的化疗药物，比如博来霉素,环磷酰胺,甲氨蝶呤,沙利度胺,和其他人,与肺部相关的毒性。这些不良反应主要源于直接毒性或免疫抑制相关感染。不太常见，可能发生免疫介导的损伤。
■医生必须高度怀疑BV引起的肺炎，因此，早期识别，随后持有病原体，用类固醇开始免疫抑制，偶尔还有保留类固醇的药物，防止其他致命的结果。
