Pulmonary toxicity
Cyclophosphamide
Cyclophosphamide is an alkylating agent utilized in a number of chemotherapy regimens as well as for the treatment of several autoimmune disorders.
Cyclophosphamide can cause pulmonary injury, including diffuse alveolar damage, BOOP and alveolar haemorrhage. This is typically defined as early onset pneumonitis within 1-6 months after the onset of cyclophosphamide therapy. The presentation during this time includes dyspnoea, cough, fever and fatigue.
Onset of pneumonitis after 6 months after initiation of cyclophosphamide therapy is defined as late onset. This can occur months to years out from initiation of therapy. The symptom onset is slow and progresses slowly over time with worsening dyspnoea and cough. Treatment of both early or late onset pneumonitis involves drug discontinuation, and re-challenge is not recommended. In early onset pneumonitis symptoms usually resolve gradually and corticosteroids can be used for symptom improvement. Late onset pneumonitis symptoms are typically irreversible and do not respond to drug discontinuation or corticosteroids.
Leave a Reply