title: Melphalan-associated pulmonary toxicity following high-dose therapy with autologous hematopoietic stem cell transplantation.
abstract: Melphalan can rarely cause interstitial pneumonitis and fibrosis. Although it has been reported previously in patients after conventional doses, we report four cases developing diffuse interstitial pneumonitis (DIP) after high-dose melphalan-based therapy. In a 3-year period, four of 57 (7%) consecutive patients undergoing high-dose melphalan (200 mg/m2; MEL 200) were identified with DIP. Two patients who were heavily pre-treated with alkylators developed progressive respiratory failure despite high-dose steroids and eventually died. The other two patients previously treated with vincristine, adriamycin, and dexamethasone (VAD) improved dramatically on high-dose steroids with complete resolution of their pneumonitis. Melphalan should be added to the growing list of alkylators causing pulmonary toxicity.
authors: Department of Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
authors: M S
authors: MS
authors: Akasheh
authors: C O
authors: CO
authors: Freytes
authors: D H
authors: DH
authors: Vesole
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008168:Lung / Q000187:drug effects*; D008297:Male; D008558:Melphalan / Q000009:adverse effects*; D008875:Middle Aged; D014182:Transplantation, Autologous
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan