title: Increased levels of tumor necrosis factor-α involved in rituximab-related acute pulmonary fibrosis in diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  Rituximab is a chimeric anti-CD20 monoclonal antibody with murine variable regions and human IgG1 constant regions that depletes B lymphocytes. It is used with increasing frequency in the treatment of patients with other hematologic malignancies and nonhematologic diseases for its safety and efficacy. Its major adverse effects are infusion related and most commonly consist of fever, chills, dyspnea, and hypotension. Rituximab-induced lung injury, such as interstitial pneumonitis and pulmonary fibrosis, is a rare complication but has been reported.
  
  
  METHODS
  We herein report a patient with diffuse large B-cell non-Hodgkin lymphoma who developed acute pulmonary fibrosis after treatment with rituximab.
  
  
  RESULTS
  Simultaneous tumor necrosis factor (TNF)-α levels were significantly increased. The patient had a dramatic recovery that was confirmed by a repeated computed tomography scan, and the levels of TNF-α returned to normal after 2 weeks of methylprednisolone treatment.
  
  
  CONCLUSIONS
  We observe that increased TNF-α levels may be involved in rituximab-related acute pulmonary fibrosis.
authors: From the Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China. jakey3456@sina.com.cn.
authors: Xueya
authors: X
authors: Zhang
authors: From the Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China.
authors: Xizhe
authors: X
authors: Guo
authors: From the Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China.
authors: Jingxin
authors: J
authors: Pan
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D058846:Antibodies, Monoclonal, Murine-Derived; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008775:Methylprednisolone
keywords: Hematology; Management/administration; Pulmonary