Etiology

• Clinical Indications
  • Lymphocytic Disorders

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Physiology

• Alkylating Agent

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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

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References

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