Severe interstitial pneumonitis associated with docetaxel administration.
BACKGROUND
Interstitial pneumonitis has not been reported as a toxicity of docetaxel. The authors report the presentation and natural history of four patients who developed a severe interstitial pneumonitis after receiving docetaxel.


METHODS
The hospital and outpatient records of patients treated with docetaxel were reviewed to identify whether any of these patients required an evaluation for respiratory problems.


RESULTS
Four patients developed an interstitial pneumonitis that could be explained only as a toxicity of docetaxel. None had metastatic disease to the lung, and all had normal liver function before receiving chemotherapy. The patients presented with acute dyspnea and fever within 1-2 weeks of receiving docetaxel. All developed progressive interstitial infiltrates and respiratory failure that required mechanical ventilation. An exhaustive workup for other causes of pneumonitis was negative. Broad-spectrum antibiotics and corticosteroids were ineffective. Two patients died of complications related to the pulmonary process. The two survivors required ventilatory support for more than 21 days. The clinical and pathologic findings of these patients are presented.


CONCLUSIONS
Interstitial pneumonitis is a rare and potentially fatal complication of docetaxel treatment. Prolonged ventilatory support is appropriate in patients with a favorable prognosis.
Read
William L
WL
Department of Medicine, Division of Medical Oncology at Washington University, St. Louis, Missouri, USA. readw@medicine.wustl.edu
Mortimer
Joanne E
JE
Picus
Joel
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D000077143:Docetaxel; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy; D012121:Respiration, Artificial; D043823:Taxoids; D014594:Uterine Neoplasms / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel