硼替佐米治疗多发性骨髓瘤后严重肺损伤二例报告并文献复习

摘要

目的 分析复发多发性骨髓瘤(MM)患者接受硼替佐米治疗后患者出现严重肺损伤的情况,提高对硼替佐米副作用的认识.方法 报道2例复发MM患者接受硼替佐米联合地塞米松或沙利度胺的化疗过程中出现严重肺损伤并复习文献.结果 2例复发MM患者在应用硼替佐米治疗过程中出现哮喘、呼吸困难、发热、低氧血症.胸部X线片提示肺部感染,细菌学检查无阳性发现,广谱抗生素治疗无效,糖皮质激素治疗有效.结论 硼替佐米治疗MM导致严重肺损伤尽管少见,但预后凶险,值得重视.预防性应用激素可能降低肺损伤的发生率.%Objective To report two cases of severe pulmonary complication after bortezomib treatment for multiple myeloma. Methods Two cases of severe pulmonary complication after bortezomib treatment patients with relapsed multiple myeloma wereas discussed with review of literature. Results Two relapsed MM patients were treated with bortezomib and thalidomide or dexametbasone. Cough, dyspnea, fever and hypoxia developed after completion of bortezomib. Chest X-ray revealed bilateral pulmonary infiltrates,but infection was not identified with sputum cultures, and broad-spectrum antibiotics were ineffective.Conclusion Severe pulmonary injury was rare complication in patients receiving treatment for multiple myeloma, however, it was a life-threatening disorder. Prophylaxis corticosteroids maybe effective. Although corticosteroids are effective, but the mechanism of lung injury associated with bortezomib is unclear, and further evaluation of this potential toxicity is appropriate.