Nozaki, Kenji and Ezoe, Sachiko and Hamaguchi, Masanari and Tsutsumi, Kazuhito and Kusakabe, Shinsuke and Morikawa, Yoichiro and Fujita, Jiro and Fukushima, Kentaro and Maeda, Tetsuo and Shibayama, Hirohiko and Kumanogo, Atsushi and Kanakura, Yuzuru (2019) Unexpected Complication of R-CHOP Chemotherapy: Rapidly Progressive Bronchiolitis Obliterans Syndrome. European Journal of Case Reports in Internal Medicine, 6 (11). ISSN 2284-2594
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Abstract
Background: Bronchiolitis obliterans syndrome (BOS) is the term used for the progressive obliteration of small airways before the patient has had a confirmatory lung biopsy. It is also recognized as a transplant-related complication. There have been no reports of BOS during initial standard chemotherapy. Case presentation: A 50-year-old woman with newly diagnosed follicular lymphoma grade 2, stage 3A, presented with hypoxia and progressive dyspnoea after the fifth cycle of R-CHOP. High-resolution computed tomography showed air trapping enhanced at the end-expiratory phase. Pulmonary function testing revealed severe obstructive and restrictive failure without bronchodilator response. We diagnosed BOS based on current criteria and treated the patient with glucocorticoids and cyclosporin. She was discharged home on oxygen therapy. However, soon after discharge, her respiratory symptoms deteriorated and she was hospitalized in a palliative care unit. She died of respiratory failure within a year of symptom onset. Conclusions: This is the first case report to describe rapidly progressive BOS in a patient undergoing R-CHOP treatment, which strongly suggests the condition was caused by the chemotherapy. Although a pathological diagnosis was not obtained, the clinical diagnosis of BOS was important so that the patient could receive appropriate treatment and palliative care based on the prognosis of this incurable condition.
| Item Type: | Article |
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| Uncontrolled Keywords: | Bronchiolitis obliterans syndrome, follicular lymphoma, R-CHOP, chemotherapy-related |
| Subjects: | 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) |
| Depositing User: | Chiara D'Arpa |
| Date Deposited: | 19 Nov 2020 09:17 |
| Last Modified: | 19 Nov 2020 09:17 |
| URI: | http://eprints.bice.rm.cnr.it/id/eprint/19569 |
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