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Cytarabine-related lung infiltrates on high resolution computerized tomography: a possible complication with benign outcome in leukemic patients

Department of Oncology and Hematology, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy

Correspondence: M. Luppi, Department of Oncology and Hematology, Policlinico, Modena, Italy. Tel: +39.059.4224641; Fax: +39.059.4224549. E-mail: mluppi{at}unimore.it

Potentially fatal lung toxicity occurs in 12–20% of leukemic patients treated with cytarabine especially at intermediate to high doses, usually presenting as noncardiogenic pulmonary edema (NCPE). Anecdotally the association between cytarabine and the onset of bronchiolitis obliterans organizing pneumonia (BOOP) has been reported. We describe here three cases of patients affected by acute myeloid leukemia (AML) treated with chemotherapeutic regimens including high dose cytarabine, who developed early onset of fever, mild dyspnea, moderate hypoxemia on arterial blood gas analysis and lung infiltrates documented by high-resolution computerized tomography (HRCT), with a more indolent behaviour and a benign clinical outcome, compared with similar cases previously reported in the literature. Our cases widen the spectrum of clinical features of cytarabine-related toxicity in leukemic patients.

Key words: cytarabine, lung infiltrates, leukemia, HRCT.

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