Antineoplastics
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Reactions 1282 - 12 Dec 2009 S Antineoplastics Pancytopenia in an elderly patient: case report A 66-year-old man developed pancytopenia during treatment with cyclophosphamide, doxorubicin, vincristine and prednisolone for lymphomatoid granulomatosis. The man presented with worsening dyspnoea, flu-like symptoms and difficulty breathing; 4 days earlier, he had received a provisional diagnosis of community-acquired pneumonia and had started receiving levofloxacin and oxygen. Chest x-ray and CT scan were suggestive of interstitial pneumonia and methylprednisolone sodium succinate was added to levofloxacin treatment. However, his respiratory status deteriorated and he was intubated and mechanically ventilated. Following further pathological and immunohistochemical investigations, he was diagnosed with lymphomatoid granulomatosis and started receiving high-dose steroids and rituximab. He was extubated 4 days later, after which the treatment was continued with cyclophosphamide, vincristine, doxorubicin and prednisolone [dosages not stated]. He showed gradual resolution of clinical and x-ray findings. However, after an unspecified duration, he developed pancytopenia related to chemotherapy along with septic shock and acute renal failure. The man received pressors for septic shock and aggressive management for renal failure. His condition did not improve and, 4 weeks later, he was terminally weaned as per his family wishes. A chest-only autopsy showed diffuse alveolar damage, likely secondary to chemotherapy or sepsis or both. Makol A, et al. Lymphomatoid granulomatosis masquerading as interstitial pneumonia in a 66-year-old man: a case report and review of literature. Journal of Hematology & Oncology 2: 160-162, No. 39, Sep 2009 - USA 801154952 1 Reactions 12 Dec 2009 No. 1282 0114-9954/10/1282-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1282 - 12 Dec 2009
SAntineoplastics
Pancytopenia in an elderly patient: case reportA 66-year-old man developed pancytopenia during
treatment with cyclophosphamide, doxorubicin, vincristineand prednisolone for lymphomatoid granulomatosis.
The man presented with worsening dyspnoea, flu-likesymptoms and difficulty breathing; 4 days earlier, he hadreceived a provisional diagnosis of community-acquiredpneumonia and had started receiving levofloxacin andoxygen. Chest x-ray and CT scan were suggestive ofinterstitial pneumonia and methylprednisolone sodiumsuccinate was added to levofloxacin treatment. However,his respiratory status deteriorated and he was intubatedand mechanically ventilated. Following further pathologicaland immunohistochemical investigations, he wasdiagnosed with lymphomatoid granulomatosis and startedreceiving high-dose steroids and rituximab. He wasextubated 4 days later, after which the treatment wascontinued with cyclophosphamide, vincristine,doxorubicin and prednisolone [dosages not stated]. Heshowed gradual resolution of clinical and x-ray findings.However, after an unspecified duration, he developedpancytopenia related to chemotherapy along with septicshock and acute renal failure.
The man received pressors for septic shock andaggressive management for renal failure. His condition didnot improve and, 4 weeks later, he was terminally weanedas per his family wishes.
A chest-only autopsy showed diffuse alveolar damage,likely secondary to chemotherapy or sepsis or both.Makol A, et al. Lymphomatoid granulomatosis masquerading as interstitialpneumonia in a 66-year-old man: a case report and review of literature. Journal ofHematology & Oncology 2: 160-162, No. 39, Sep 2009 - USA 801154952
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Reactions 12 Dec 2009 No. 12820114-9954/10/1282-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
