Chlorambucil-Induced Acute Interstitial Pneumonitis

Table 1

Reports of chlorambucil-induced interstitial lung disease.

Report, year	Clinical information	Diagnosis of pneumonitis	Cumulative chlorambucil dose	Duration of therapy (months)	Treatment and outcome
Rubio 1972 [4]	Four patients; CLL; Tobacco: NR	OLB in 2 cases	NR	NR	NR; All expired
Rose 1975 [5]	67-year-old female; CLL; Tobacco: NR	NR	NR	15	NR
Refvem 1977 [6]	60-year-old male; CLL; Tobacco: NR	Autopsy: alveolar epitheliolysis and fibrosis	2500 mg + prednisolone	~9	Multiple antibiotics; Expired
Cole et al. 1978 [7]	60-year-old female; polycythemia vera; Tobacco: none	OLB: interstitial fibrosis	4130 mg	22	Methylprednisolone; Improved
Godard et al. 1979 [8]	67-year-old male; CLL; Tobacco: 30 py	OLB: interstitial pneumonitis	7500 mg	36	Improved
Lane et al. 1981 [9]	74-year-old black male; CLL; Tobacco: NR	OLB: focal interstitial fibrosis	161 mg + prednisone	6	Prednisone; Expired
Carr 1986 [10]	62-year-old white male; CLL; Tobacco: NR	OLB: interstitial fibrosis	4300 mg	56	Prednisone; Improved
Giles et al. 1990 [11]	67-year-old male; CLL; Tobacco: NR	Transbronchial biopsy: desquamative interstitial pneumonitis	2016 mg + prednisone	44	Expired
Mohr et al. 1993 [12]	57-year-old male; CLL; Tobacco: NR	BAL	640 mg	6	Prednisone, IVIG; Improved
Crestani et al. 1994 [13]	48-year-old male; CLL; Tobacco: none	BAL	8340 mg	44	Improved
Khong and McCarthy 1998 [14]	77-year-old male; CLL; Tobacco: 45 py	OLB: interstitial fibrosis	2700 mg	60	Prednisone; Improved
Tomlinson et al. 1999 [15]	70-year-old male; B-cell lymphoma; Tobacco: NR	Transbronchial biopsy: organizing pneumonia	200 mg + mitoxantrone and prednisone	1.5	Prednisolone; Improved; (Rechallenged with chlorambucil without recurrence)
	56-year-old female; B-cell lymphoma; Tobacco: NR	OLB: interstitial infiltrates with eosinophils	600 mg + mitoxantrone and prednisone	6	Improved
Kalambokis et al. 2004 [16]	70-year-old male; CLL; Tobacco: NR	OLB: bronchiolitis obliterans organizing pneumonia	200 mg + mehtylprednisolone	1.5	Improved
Current report	83-year-old male; CLL; Tobacco: 60 py	CT scan only	456 mg	6	Prednisone; Improved

Abbreviations: BAL: bronchoalveolar lavage; IVIG: intravenous immunoglobulin; NR: not recorded; OLB: open lung biopsy; py: pack-year.