Severe pulmonary complications in Japanese patients after bortezomib treatment for refractory multiple myeloma.
Bortezomib is a novel proteasome inhibitor with significant antimyeloma activity. Its frequent adverse effects are manageable, including gastrointestinal symptoms, peripheral neuropathy, and thrombocytopenia. Severe lung toxicity has not previously been reported. Between June 2004 and September 2005, 13 Japanese patients with multiple myeloma were treated with bortezomib in Toranomon Hospital, Juntendo University School of Medicine, and Jichi Medical School. Four of them developed severe pulmonary complications, and 2 died of respiratory failure without progression of underlying disease. To our knowledge, this is the first report on life-threatening pulmonary adverse effects after bortezomib therapy. Previous clinical studies on bortezomib, mostly in the United States and Europe, have shown low incidences of pulmonary adverse effects. Our study suggests that bortezomib can cause serious lung injury, and that its incidence might vary among different ethnicities. Clinicians need to be alert to the possibility.
Miyakoshi
Shigesaburo
S
Department of Hematology, Toranomon Hospital, 2-2-2, Toranomon, Tokyo, Japan. s-miyakoshi@toranomon.gr.jp
Kami
Masahiro
M
Yuji
Koichiro
K
Matsumura
Tomoko
T
Takatoku
Masaaki
M
Sasaki
Makoto
M
Narimatsu
Hiroto
H
Fujii
Takeshi
T
Kawabata
Masateru
M
Taniguchi
Shuichi
S
Ozawa
Keiya
K
Oshimi
Kazuo
K
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D007564:Japan; D008168:Lung / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D010996:Pleural Effusion / Q000139:chemically induced; D011480:Protease Inhibitors / Q000009:adverse effects*; D011719:Pyrazines / Q000009:adverse effects*; D012131:Respiratory Insufficiency / Q000139:chemically induced
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011480:Protease Inhibitors; D011719:Pyrazines; D000069286:Bortezomib