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Severe pulmonary toxicity related to carfilzomib use: a rare but serious side effect
  1. Arthi Sridhar1,
  2. Binoy Yohannan2,
  3. Johncy John Kachira3 and
  4. Sameeksha Bhama2
  1. 1Division of Hematology and Oncology, University of Texas McGovern Medical School, Houston, Texas, USA
  2. 2Hematology and Oncology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  3. 3The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Arthi Sridhar; artshri{at}gmail.com

Abstract

Carfilzomib is a selective proteosome inhibitor that is commonly used in the treatment of relapsed or refractory multiple myeloma. Carfilzomib has been commonly associated with respiratory side effects. It can rarely also cause fatal pulmonary toxicity. We present a case of a man in his 50s with plasma cell leukaemia who was initiated on treatment with carfilzomib and dexamethasone. He developed severe pneumonitis requiring oxygen via a high-flow nasal cannula. After an extensive workup, a temporal relationship between the carfilzomib use and exacerbation of the pulmonary symptoms was found. Carfilzomib was permanently discontinued, and the patient was started promptly on methyl prednisolone with complete resolution of his symptoms. Due to the associated risk of mortality if not detected early, we wish to highlight this rare but serious pulmonary toxicity associated with carfilzomib that was managed with high-dose glucocorticoids.

  • Chemotherapy
  • Haematology (incl blood transfusion)
  • Respiratory medicine
  • Oncology

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Footnotes

  • Contributors AS: conception, design, data acquisition, literature review and drafting of manuscript. BY and JJK: critically revised the manuscript for important intellectual content. SB: contributed to the revision and final approval of the paper. All authors agree to be accountable for the accuracy of the work, and read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.