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A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy

We present a 74-year-old male with nonspecific interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle cell lymphoma. Previously, the patient had received six cycles of bendamustine and rituximab and six cycles of R-CHOP, followed by rituximab maintenance therapy. Respiratory tract...

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Autores principales: Jungmann, Sven, Ludwig, Wolf-Dieter, Schönfeld, Nicolas, Blum, Torsten-Gerriet, Großwendt, Claudia, Boch, Christian, Rehbock, Beate, Griff, Sergej, Schmittel, Alexander, Bauer, Torsten T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702410/
https://www.ncbi.nlm.nih.gov/pubmed/29259834
http://dx.doi.org/10.1155/2017/5640186
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author Jungmann, Sven
Ludwig, Wolf-Dieter
Schönfeld, Nicolas
Blum, Torsten-Gerriet
Großwendt, Claudia
Boch, Christian
Rehbock, Beate
Griff, Sergej
Schmittel, Alexander
Bauer, Torsten T.
author_facet Jungmann, Sven
Ludwig, Wolf-Dieter
Schönfeld, Nicolas
Blum, Torsten-Gerriet
Großwendt, Claudia
Boch, Christian
Rehbock, Beate
Griff, Sergej
Schmittel, Alexander
Bauer, Torsten T.
author_sort Jungmann, Sven
collection PubMed
description We present a 74-year-old male with nonspecific interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle cell lymphoma. Previously, the patient had received six cycles of bendamustine and rituximab and six cycles of R-CHOP, followed by rituximab maintenance therapy. Respiratory tract complications of ibrutinib other than infectious pneumonia have not been mentioned in larger trials, but individual case reports hinted to a possible association with the development of pneumonitis. In our patient, the onset of alveolitis that progressed towards NSIP together with the onset of ibrutinib treatment suggests causality. One week after ibrutinib was discontinued, nasal symptoms resolved first. A follow-up CT showed a reduction in the reticular hyperdensities and ground-glass opacities, suggestive of restitution of the lung disease. To our knowledge, this is the first case showing a strong link between ibrutinib and interstitial lung disease, strengthening a previous report on subacute pneumonitis. Our findings have clinical implications because pulmonary side effects were reversible at this early stage. We, therefore, suggest close monitoring for respiratory side effects in patients receiving ibrutinib.
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spelling pubmed-57024102017-12-19 A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy Jungmann, Sven Ludwig, Wolf-Dieter Schönfeld, Nicolas Blum, Torsten-Gerriet Großwendt, Claudia Boch, Christian Rehbock, Beate Griff, Sergej Schmittel, Alexander Bauer, Torsten T. Case Rep Oncol Med Case Report We present a 74-year-old male with nonspecific interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle cell lymphoma. Previously, the patient had received six cycles of bendamustine and rituximab and six cycles of R-CHOP, followed by rituximab maintenance therapy. Respiratory tract complications of ibrutinib other than infectious pneumonia have not been mentioned in larger trials, but individual case reports hinted to a possible association with the development of pneumonitis. In our patient, the onset of alveolitis that progressed towards NSIP together with the onset of ibrutinib treatment suggests causality. One week after ibrutinib was discontinued, nasal symptoms resolved first. A follow-up CT showed a reduction in the reticular hyperdensities and ground-glass opacities, suggestive of restitution of the lung disease. To our knowledge, this is the first case showing a strong link between ibrutinib and interstitial lung disease, strengthening a previous report on subacute pneumonitis. Our findings have clinical implications because pulmonary side effects were reversible at this early stage. We, therefore, suggest close monitoring for respiratory side effects in patients receiving ibrutinib. Hindawi 2017 2017-11-10 /pmc/articles/PMC5702410/ /pubmed/29259834 http://dx.doi.org/10.1155/2017/5640186 Text en Copyright © 2017 Sven Jungmann et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Jungmann, Sven
Ludwig, Wolf-Dieter
Schönfeld, Nicolas
Blum, Torsten-Gerriet
Großwendt, Claudia
Boch, Christian
Rehbock, Beate
Griff, Sergej
Schmittel, Alexander
Bauer, Torsten T.
A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title_full A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title_fullStr A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title_full_unstemmed A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title_short A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy
title_sort patient with non-hodgkin lymphoma and nonspecific interstitial pneumonia during ibrutinib therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702410/
https://www.ncbi.nlm.nih.gov/pubmed/29259834
http://dx.doi.org/10.1155/2017/5640186
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