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June 1977, Vol 131, No. 6 >
Article | June 1977

Busulf an Lung FREE

Marilyn Pearl, MD
[+] Author Affiliations

Reprint requests to Department of Radiology, Pediatric Radiology Division, Metropolitan Hospital Center, 1901 First Ave, New York, NY 10029 (Dr Pearl).


Am J Dis Child. 1977;131(6):650-652. doi:10.1001/archpedi.1977.02120190044009.
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• An uncommon, but lethal, toxic side effect of busulfan (Myleran) therapy for chronic myelogenous leukemia is pulmonary fibrosis. A 16-month-old male infant treated for 11 months with busulfan for chronic myelogenous leukemia is, we believe, the first case of "busulfan lung" in the pediatric age group to be reported. Progressive roentgenographic changes in the lung of a diffuse intra-alveolar and interstitial pattern were noted. The patient died after a four-day episode of cough, fever, and progressive dyspnea. At autopsy, no evidence of infection or leukemic infiltrates were seen in the lungs. Characteristic histologic findings as a result of busulfan therapy were observed in the lung and pancreas.

(Am J Dis Child 131:650-652, 1977)

REFERENCES

1 +
Galton DAG:  Myleran in chronic myeloid leukemia: Results of treatment . Lancet 1:208-213, 1953;.
2 +
Moloney WC: Current Therapy 1971 , Conn HF (ed). Philadelphia, WB Saunders Co, 1971;.
3 +
Burns WA, McFarland W, Matthews MJ:  Toxic manifestations of busulfan therapy . Med Ann DC 40:567-572, 1971;.
4 +
Wilkinson JF, Turner RL:  Chemotherapy of chronic myeloid leukemia, with special reference to Myleran , in Tocantins LM (ed): Progress in Hematology , New York, Grune & Stratton Inc, 1959;, vol 2, p 225.
5 +
Galton DAG, Till M, Wiltshaw E: Busulfan:  Summary of clinical results . Ann NY Acad Sci 68:967-973, 1958;.
6 +
Schein PS, Winokur SH:  Immunosuppressive and cytotoxic chemotherapy: Long term complications . Ann Intern Med 82:84-95, 1975;.
7 +
Davies PDB:  Drug induced lung disease . Br J Dis Chest 63:57-70, 1969;.
8 +
Bergert EO Jr, Nieri RL, Mills SD, et al:  Nonlymphocytic leukemia in childhood . Mayo Clin Proc 48:255-259, 1973;.
9 +
Nicklaus TM, Snyder AB:  Nitrofurantoin pulmonary reaction . Arch Intern Med 121:151-155, 1968;.
10 +
Heard BE:  Fibrous healing of old iatrogenic pulmonary edema (hexamethonium lung) . J Pathol Bacteriol 83:159-165, 1962;.
11 +
Rodin AE, Haggard ME, Travis LB:  Lung changes and chemotherapeutic agents in childhood: Report of a case associated with cyclophosphamide therapy . Am J Dis Child 120:337-340, 1970;.
12 +
Huxtable KA, Bolande RP, Klaus M:  Experimental furniture polish pneumonia in rats . Pediatrics 34:228-235, 1964;.
13 +
Heard BE, Steiner RE, Herdan A, et al:  Oedema and fibrosis of the lungs in left ventricular failure . Br J Radiol 41:161-171, 1968;.
14 +
Hopps HC, Wissler RW:  Uremic pneumonitis . Am J Pathol 31:261-273, 1955;.
15 +
Nash G, Blennerhassett JB, Pontoppidan H:  Pulmonary lesions associated with oxygen therapy and artificial ventilation . N Engl J Med 276:368-374, 1967;.
16 +
Jennings FL, Arden A:  Development of radiation pneumonitis . Arch Pathol 74:351-360, 1962;.
17 +
Oliner H, Schwartz R, Rubio S, et al:  Interstitial pulmonary fibrosis following busulfan therapy . Am J Med 31:134-139, 1961;.
18 +
Feingold ML, Koss LG:  Effects of long-term administration of busulfan . Arch Intern Med 124:66-71, 1969;.
19 +
Heard BE, Cooke RA:  Busulfan lung . Thorax 23:187-193, 1968;.
20 +
Kirschner RH, Esterly JR:  Pulmonary lesions associated with busulfan therapy of chronic myelogenous leukemia . Cancer 27:1074-1080, 1971;.
21 +
Podall LN, and Winkler S:  Busulfan lung . Am J Roentgenol Radium Ther Nucl Med 120:151-156, 1974;.
22 +
Brynes RK, Mostafavipour SH, Fennessy JJ, et al:  Diagnosis of busulfan lung by transcatheter biopsy . Chest 64:771-773, 1973;.
23 +
Koss LG, Melamid MR, Mayer K:  The effect of busulfan in human epithia . Am J Clin Pathol 44:385-397, 1965;.

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References

1 +
Galton DAG:  Myleran in chronic myeloid leukemia: Results of treatment . Lancet 1:208-213, 1953;.
2 +
Moloney WC: Current Therapy 1971 , Conn HF (ed). Philadelphia, WB Saunders Co, 1971;.
3 +
Burns WA, McFarland W, Matthews MJ:  Toxic manifestations of busulfan therapy . Med Ann DC 40:567-572, 1971;.
4 +
Wilkinson JF, Turner RL:  Chemotherapy of chronic myeloid leukemia, with special reference to Myleran , in Tocantins LM (ed): Progress in Hematology , New York, Grune & Stratton Inc, 1959;, vol 2, p 225.
5 +
Galton DAG, Till M, Wiltshaw E: Busulfan:  Summary of clinical results . Ann NY Acad Sci 68:967-973, 1958;.
6 +
Schein PS, Winokur SH:  Immunosuppressive and cytotoxic chemotherapy: Long term complications . Ann Intern Med 82:84-95, 1975;.
7 +
Davies PDB:  Drug induced lung disease . Br J Dis Chest 63:57-70, 1969;.
8 +
Bergert EO Jr, Nieri RL, Mills SD, et al:  Nonlymphocytic leukemia in childhood . Mayo Clin Proc 48:255-259, 1973;.
9 +
Nicklaus TM, Snyder AB:  Nitrofurantoin pulmonary reaction . Arch Intern Med 121:151-155, 1968;.
10 +
Heard BE:  Fibrous healing of old iatrogenic pulmonary edema (hexamethonium lung) . J Pathol Bacteriol 83:159-165, 1962;.
11 +
Rodin AE, Haggard ME, Travis LB:  Lung changes and chemotherapeutic agents in childhood: Report of a case associated with cyclophosphamide therapy . Am J Dis Child 120:337-340, 1970;.
12 +
Huxtable KA, Bolande RP, Klaus M:  Experimental furniture polish pneumonia in rats . Pediatrics 34:228-235, 1964;.
13 +
Heard BE, Steiner RE, Herdan A, et al:  Oedema and fibrosis of the lungs in left ventricular failure . Br J Radiol 41:161-171, 1968;.
14 +
Hopps HC, Wissler RW:  Uremic pneumonitis . Am J Pathol 31:261-273, 1955;.
15 +
Nash G, Blennerhassett JB, Pontoppidan H:  Pulmonary lesions associated with oxygen therapy and artificial ventilation . N Engl J Med 276:368-374, 1967;.
16 +
Jennings FL, Arden A:  Development of radiation pneumonitis . Arch Pathol 74:351-360, 1962;.
17 +
Oliner H, Schwartz R, Rubio S, et al:  Interstitial pulmonary fibrosis following busulfan therapy . Am J Med 31:134-139, 1961;.
18 +
Feingold ML, Koss LG:  Effects of long-term administration of busulfan . Arch Intern Med 124:66-71, 1969;.
19 +
Heard BE, Cooke RA:  Busulfan lung . Thorax 23:187-193, 1968;.
20 +
Kirschner RH, Esterly JR:  Pulmonary lesions associated with busulfan therapy of chronic myelogenous leukemia . Cancer 27:1074-1080, 1971;.
21 +
Podall LN, and Winkler S:  Busulfan lung . Am J Roentgenol Radium Ther Nucl Med 120:151-156, 1974;.
22 +
Brynes RK, Mostafavipour SH, Fennessy JJ, et al:  Diagnosis of busulfan lung by transcatheter biopsy . Chest 64:771-773, 1973;.
23 +
Koss LG, Melamid MR, Mayer K:  The effect of busulfan in human epithia . Am J Clin Pathol 44:385-397, 1965;.

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