Lenalidomide is a derivative of thalidomide and is FDA-approved for the treatment of myelodysplastic syndrome and, in combination with dexamethasone, for the treatment of relapsed multiple myeloma. Pulmonary toxicity with thalidomide is a recognized potential complication; however, there have only been two case reports in the literature of lenalidomide-associated pulmonary toxicity. In this case, we describe a patient who developed profound dyspnea, decreased exercisetolerance, and new ground-glass opacities with reticulation, consistent with a nonspecific interstitial pneumonia pattern. ⋯ Within 2 weeks of stopping lenalidomide, the patient had significant improvement in dyspnea and interstitial changes on CT were resolving. After 8 weeks, there was complete resolution of symptoms. Lenalidomide-induced pulmonary toxicity is significantly debilitating but, to date, it appears to be reversible with discontinuation of the medication.
Stephanie Coates, Alan Barker, and Stephen Spurgeon.
Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR 97239, USA. coates@ohsu.edu
J Oncol Pharm Pract. 2012 Jun 1;18(2):284-6.
AbstractLenalidomide is a derivative of thalidomide and is FDA-approved for the treatment of myelodysplastic syndrome and, in combination with dexamethasone, for the treatment of relapsed multiple myeloma. Pulmonary toxicity with thalidomide is a recognized potential complication; however, there have only been two case reports in the literature of lenalidomide-associated pulmonary toxicity. In this case, we describe a patient who developed profound dyspnea, decreased exercisetolerance, and new ground-glass opacities with reticulation, consistent with a nonspecific interstitial pneumonia pattern. Clinical suspicion for pulmonary drug toxicity was high and lenalidomide was discontinued. Within 2 weeks of stopping lenalidomide, the patient had significant improvement in dyspnea and interstitial changes on CT were resolving. After 8 weeks, there was complete resolution of symptoms. Lenalidomide-induced pulmonary toxicity is significantly debilitating but, to date, it appears to be reversible with discontinuation of the medication.