Severe pulmonary complications in Japanese patients after bortezomib treatment for refractory multiple myeloma

Bortezomib is a novel proteasome inhibitor with significant antimyeloma activity. Its frequent adverse effects are manageable, including gastrointestinal symptoms, peripheral neuropathy, and thrombocytopenia. Severe lung toxicity has not previously been reported. Between June 2004 and September 2005...

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Bibliographic Details
Published in:Blood 2006-05, Vol.107 (9), p.3492-3494
Main Authors: Miyakoshi, Shigesaburo, Kami, Masahiro, Yuji, Koichiro, Matsumura, Tomoko, Takatoku, Masaaki, Sasaki, Makoto, Narimatsu, Hiroto, Fujii, Takeshi, Kawabata, Masateru, Taniguchi, Shuichi, Ozawa, Keiya, Oshimi, Kazuo
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - adverse effects
Biological and medical sciences
Boronic Acids - adverse effects
Bortezomib
Drug toxicity and drugs side effects treatment
Female
Humans
Immunodeficiencies. Immunoglobulinopathies
Immunoglobulinopathies
Immunopathology
Japan
Lung - drug effects
Lung - pathology
Lung - physiopathology
Male
Medical sciences
Middle Aged
Multiple Myeloma - drug therapy
Pharmacology. Drug treatments
Pleural Effusion - chemically induced
Protease Inhibitors - adverse effects
Pyrazines - adverse effects
Respiratory Insufficiency - chemically induced
Toxicity: respiratory system, ent, stomatology
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Summary:Bortezomib is a novel proteasome inhibitor with significant antimyeloma activity. Its frequent adverse effects are manageable, including gastrointestinal symptoms, peripheral neuropathy, and thrombocytopenia. Severe lung toxicity has not previously been reported. Between June 2004 and September 2005, 13 Japanese patients with multiple myeloma were treated with bortezomib in Toranomon Hospital, Juntendo University School of Medicine, and Jichi Medical School. Four of them developed severe pulmonary complications, and 2 died of respiratory failure without progression of underlying disease. To our knowledge, this is the first report on life-threatening pulmonary adverse effects after bortezomib therapy. Previous clinical studies on bortezomib, mostly in the United States and Europe, have shown low incidences of pulmonary adverse effects. Our study suggests that bortezomib can cause serious lung injury, and that its incidence might vary among different ethnicities. Clinicians need to be alert to the possibility.
ISSN:0006-4971
1528-0020
DOI:10.1182/blood-2005-11-4541