Chlorambucil

Etiology

  • Clinical Indications
    • Lymphocytic Disorders

Physiology

  • Alkylating Agent

Adverse Effects

Pulmonary

  • Interstitial Pulmonary Fibrosis (see Interstitial Lung Disease-Etiology)
    • Epidemiology
      • Cumulative Dose Effect: doses >2g significantly increase the risk of pulmonary toxicity
    • Diagnosis
      • PFT’s: decreased DLCO may predict those who will develop pulmonary toxicity
    • Clinical
      • Delayed and Insidiuous Onset: symptoms occur 6-12 months after start of therapy
      • Dyspnea, cough, fever
    • Treatment/Prognosis: unclear if steroids have any benefit
  • Cryptogenic Organizing Pneumonia (see Cryptogenic Organizing Pneumonia and Lung Nodule or Mass)
    • May appear as nodular infiltrates

References

  • Chlorambucil-associated pneumonitis. Chest 1994;105;634-636