Delayed pulmonary fibrosis after nitrosourea therapy

Article Abstract:

Many chemotherapeutic drugs used to treat cancer can have adverse effects on the lungs, causing injury and fibrosis (the formation of scar tissue). These pulmonary reactions can be fatal, which raise difficult questions about the advisability of using certain chemotherapeutic agents. The drug bleomycin leads to fibrosis in 1 out of 10 patients, and 1 in 10 of affected patients die from fibrosis. The class of drugs known as nitrosourea compounds has also caused pulmonary reactions. Cases of lung fibrosis due to chemotherapy with one of the nitrosourea drugs, carmustine (BCNU), were reviewed by O'Driscoll and colleagues in the August 9, 1990 issue of the New England Journal of Medicine. The subjects were eight individuals treated for brain tumors as children; they were evaluated for fibrosis an average of 14 years later. All eight subjects had lung injury and fibrosis with impaired respiratory function, although not all had symptoms. During the early years of chemotherapy with carmustine, it was thought that the drug had no toxic effects on the lungs. However, since 1976, there have been 70 reported cases of pulmonary toxicity associated with carmustine; the mortality of this serious condition is over 50 percent. Symptoms of fibrosis may develop many years after the carmustine therapy, and include shortness of breath, rapid breathing, and a cough. Patients at greatest risk for carmustine-induced lung fibrosis are those given high doses, those treated at a younger age, smokers, and patients with pre-existing lung disease. Patients given radiotherapy at the same time as the carmustine also appear to be at increased risk. O'Driscoll's report suggests that injury to the lungs may occur in all patients given carmustine, even those with no symptoms. It is important that all patients who receive carmustine continue to be monitored regularly for lung fibrosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Cancer patients, Cancer in children, Childhood cancer, Chemotherapy, Pulmonary fibrosis, editorial, Carmustine

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Pulmonary Langerhans'-cell histiocytosis

Article Abstract:

Langerhans'-cell histiocytosis is a disease characterized by a proliferation of cells called Langerhans cells. These are immune system cells and the proliferation can cause cell deposits in various organs. The exact cause of the proliferation is not known, but cigarette smoke is known to cause Langerhans cells to accumulate in the lungs. About 90% of patients with Langerhans'-cell histiocytosis in the lungs are smokers. The symptoms may resemble cancer. Bronchoalveolar lavage or lung biopsy can confirm the diagnosis. Smoking cessation should always be recommended, and corticosteroids and some chemotherapy drugs may be beneficial.

Lung diseases, Reticuloendotheliosis

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Pneumocysts pneumonia

Article Abstract:

The progress that has resulted from the studies of the cell biology, biochemistry, and genetics of pneumocystis is described. Several recommendations for the diagnosis of pneumocystis pneumonia, as well as for prophylaxis treatment are presented.

United States, Science & research, Research, Pneumocystis carinii pneumonia, Prophylaxis

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