Document Detail

Fatal pulmonary failure complicating high-dose cytosine arabinoside therapy in acute leukemia.
MedLine Citation:
PMID:  2302659     Owner:  NLM     Status:  MEDLINE    
One hundred three relapsed leukemia patients were treated with high-dose cytosine arabinoside (Ara-C); 3 g/m2 intravenously over 2 hours every 6 to 12 hours for a total of nine to 12 doses or 3 g/m2 intravenously over 2 hours for two doses 12 hours apart followed by a continuous infusion of 1.5 g/m2 over 24 hours daily for 3 to 4 days. Thirteen of them developed adult respiratory distress syndrome (ARDS) without having any recognized reason for the development of pulmonary edema. This problem showed no correlation with age or prior chemotherapy. Four of the patients recovered, but in nine this complication was fatal. The authors have reviewed the clinical course of these 13 patients and the postmortem findings of the seven patients who had an autopsy performed. The pulmonary tissue from six patients showed massive edema and one had diffuse alveolar damage. Histologic examination revealed a highly proteinaceous intraalveolar infiltrate without any inflammatory reaction in all cases. Intestinal tissue from all patients revealed changes compatible with cytotoxic damage, and pleura and/or pericardium from six of the seven patients showed an extensive fibrinous exudate suggestive of capillary leakage. The time sequence of the clinical events and the histologic findings indicate that high-dose Ara-C treatment in leukemia may cause a capillary leakage syndrome with ARDS that may progress to fatal respiratory failure.
B S Andersson; M A Luna; C Yee; K K Hui; M J Keating; K B McCredie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  65     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  1990 Mar 
Date Detail:
Created Date:  1990-03-27     Completed Date:  1990-03-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1079-84     Citation Subset:  AIM; IM    
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
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MeSH Terms
Acute Disease
Cytarabine / administration & dosage,  adverse effects*
Drug Administration Schedule
Intestinal Mucosa / pathology
Leukemia / drug therapy*
Lung / pathology
Middle Aged
Myocardium / pathology
Respiratory Distress Syndrome, Adult / chemically induced
Respiratory Insufficiency / chemically induced*,  pathology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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