BCNU toxicity presenting with a large pericardial and pleural effusion.
BACKGROUND
Carmustine (BCNU), 1, 3-bis (2-chloroethyl)-1-nitosourea, is an alkylating agent which is commonly used as a part of conditioning regimen for autologous peripheral blood stem cell transplantation. Despite the widespread use of BCNU therapy in adults, cardiopulmonary toxicity presenting with cardiac tamponade has not been reported.


METHODS
We present a patient who received BCNU as part of her conditioning regimen followed by autologous peripheral blood stem cell transplantation. This patient subsequently developed bilateral upper lobe pulmonary infiltrates with bilateral pleural effusions and a large pericardial effusion which was a result of BCNU toxicity.


CONCLUSIONS
Early institution of glucocorticoids for patients receiving high dose BCNU containing chemotherapeutic regimens has shown to significantly reduce BCNU induced cardio-pulmonary toxicity.
Krishnan
Ganapathy S
GS
Department of Internal Medicine, Division of Hematology and Oncology, Michigan State University, E. Lansing, MI, USA. ganakrish@gmail.com
Chaudhary
Vijay
V
Al-Janadi
Anas
A
Ramanarayanan
Jeyanthi
J
D'Silva
Karl J
KJ
D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000633:toxicity*; D004452:Echocardiography; D005260:Female; D000068298:Fluticasone; D006801:Humans; D016399:Lymphoma, T-Cell / Q000188:drug therapy* / Q000601:surgery; D010490:Pericardial Effusion / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000139:chemically induced*; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed
D000730:Androstadienes; D018906:Antineoplastic Agents, Alkylating; D000068298:Fluticasone; D002330:Carmustine