Interstitial pneumonitis as a late complication of high dose therapy with cyclophosphamide/thiotepa and peripheral blood progenitor cell rescue for carcinoma of the breast.
The incurability of metastatic breast cancer with conventional chemotherapy has prompted many units to investigate the role of high dose chemotherapy and autologous stem cell rescue in patients with advanced or poor risk primary disease. Although preliminary data from centres treating patients with these modalities are encouraging, both in terms of rapidity of haemopoietic recovery and progression free survival, there is nonetheless a procedure related toxicity. We describe a patient with inflammatory carcinoma of the breast who received high dose cyclophosphamide and thiotepa prior to peripheral blood progenitor cell rescue, and developed a steroid responsive interstitial pneumonitis 10 weeks after stem cell infusion.
Mahendra
P
P
Addenbrooke's NHS Trust, Cambridge, UK.
Hood
I M
IM
Lee
M A
MA
Mewar
D
D
Bass
G
G
Flower
C D
CD
Wilson
C B
CB
Marcus
R E
RE
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000209:etiology*; D015413:Mastectomy, Simple; D008875:Middle Aged; D013852:Thiotepa / Q000008:administration & dosage / Q000009:adverse effects*; D019172:Transplantation Conditioning
D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D013852:Thiotepa