[Nitrosourea-induced lung diseases].
Nitrosoureas belong to the group of alkylating agents, and are increasingly used in the treatment of brain malignancies, due to their excellent penetration through the hemo-meningeal barrier. Since 1976, pulmonary toxicity from nitrosoureas has emerged as a significant problem, especially with BCNU, and 72 cases are available in the literature for review. While it is difficult to ascertain the exact prevalence of nitrosourea lung (estimate range between 1 and 20%), it is now clear that a direct relationship exists between cumulated exposure to the nitrosourea, and the likelihood of developing pulmonary toxicity. The clinical picture is that of a diffuse, severe fibrosis with hypoxemia. Histopathology, available in 55 reports, showed diffuse bland fibrosis. The outcome is poor with 67% of the patients dead by the time of publication. While we feel that corticosteroids should be tried for any possible beneficial effect, they seem to be of limited help.
Massin
F
F
Service de Pneumologie et de Réanimation Respiratoire, CHU, Dijon.
Coudert
B
B
Foucher
P
P
Lombard
J N
JN
Reybet-Degat
O
O
Jeannin
L
L
Camus
P
P
D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy; D002330:Carmustine / Q000009:adverse effects; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008130:Lomustine / Q000009:adverse effects; D008168:Lung / Q000187:drug effects / Q000473:pathology; D008171:Lung Diseases / Q000139:chemically induced* / Q000473:pathology; D009607:Nitrosourea Compounds / Q000009:adverse effects*; D011014:Pneumonia / Q000139:chemically induced; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000139:chemically induced; D012307:Risk Factors; D012673:Semustine / Q000009:adverse effects
D009607:Nitrosourea Compounds; D012673:Semustine; D008130:Lomustine; D002330:Carmustine
La pneumopathie des nitrosourées.