title: Lenalidomide-induced acute lung injury in case of multiple myeloma.
abstract: OBJECTIVE
  Lenalidomide is now widely used for the treatment of multiple myeloma in virtue of its potent anti-tumor activity and low toxicity. Very few reports stressed the association of this drug with serious pulmonary toxicity. Here we present the case of multiple myeloma who underwent acute respiratory failure caused by non-specific interstitial pneumonia after few days of treatment with lenalidomide.
  
  
  METHODS
  A 50-year-old man diagnosed as multiple myeloma of IgA κ type, International Staging System III received a combination therapy of lenalidomide (15 mg, Day 1 - 21) with dexamethasone (40 mg, Day 1, 8, 15, 22). After 4 days on chemotherapy, he experienced worsened dyspnea and was urgently hospitalized because of acute respiratory failure. Because serial imaging procedures and thorough laboratory workup strongly suggested that his lung injury was caused by drug-induced interstitial pneumonia, lenalidomide, which was the most suspicious drug, was discontinued immediately, and the glucocorticoid pulse was performed. He showed an excellent response to the therapy. Interstitial pneumonia on the CT scan was resolved dramatically at 12 days after the start of the glucocorticoid pulse.
  
  
  CONCLUSIONS
  We are convinced that our case is so instructive as to arouse attention to clinicians that lenalidomide has an extremely rare but potential adverse effect.
authors.affiliation: Department of Hematology, Kitasato University School of Medicine, Japan. mikduty@med.kitasato-u.ac.jp
authors.forename: Mikio
authors.initials: M
authors.lastname: Danbara
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tadera
authors.forename: Tomiteru
authors.initials: T
authors.lastname: Togano
authors.forename: Takuji
authors.initials: T
authors.lastname: Katayama
authors.forename: Takumi
authors.initials: T
authors.lastname: Aoki
authors.forename: Koji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Higashihara
mesh_terms: D055371:Acute Lung Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011859:Radiography; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D000077269:Lenalidomide