Rituximab-Induced Severe Pulmonary Disease

Rituximab引致嚴重肺部疾病

鍾為邦(Wei-Pang Chung) ； 吳尚殷(Shang-Yin Wu) ； 葉裕民(Yu-Min Yeh) ； 陳雅萍(Ya-Ping Chen) ； 邱威鑫(Wei-Hsin Chiu) ； 林鵬展(Peng-Chan Lin) ； 蘇文彬(Wen-Pin Su) ； 顏家瑞(Chia-Jui Yen) ； 蘇五洲(Wu-Chou Su) ； 陳彩雲(Tsai-Yun Chen)

《台灣癌症醫學雜誌》 29卷2期 (2013/06) Pp. 79-83

https://doi.org/10.6323/JoCRP.2013.29.2.3

摘要

過去十數年間，莫須瘤已被廣泛運用於治療CD20陽性之B細胞淋巴瘤。根據全世界超過一百萬人的使用經驗，注射莫須瘤是相當安全與可耐受的。相關的副作用通常輕微，且大多數為發燒或寒顫等與輸注相關的反應，這一類的反應可藉由放慢輸注速率與給予前導藥物來預防，不過即便如此，仍偶有報導因莫須瘤而引發的嚴重肺部疾病，其發生率介於0.01%-0.03%之間。我們於此做一位患者的個案報告，病患為77歲男性，在接受第二次莫須瘤注射後旋即引發間質性肺炎與呼吸衰竭，細胞激素在此類疾病的致病機轉上可能具有重要地位，而這些副作用或許可經由適當地縮減腫瘤負荷及施與類固醇來預防。

關鍵字

莫須瘤 ； 淋巴瘤 ； 肺部疾病 ； 間質性肺炎 ； 類固醇

並列摘要

Rituximab has been widely used to treat CD20+ B-cell lymphoma for more than ten years. Its safety and tolerability are well established on the basis of data from more than one million patients worldwide. The side effects are usually mild, and mostly are infusion-related reactions (IRRs) such as fever and chills. IRRs can be prevented by slow administration and some premedication. However, rituximab-induced severe pulmonary disease is still occasionally reported, with an occurrence rate of 0.01-0.03%. We herein report a 77-year-old man who presented with interstitial pneumonitis and respiratory failure soon after the second infusion of rituximab. Cytokines may play an important role in the pathogenesis of rituximab-related complications. Such side effects may be prevented by appropriate cytoreduction of the tumor and premedication with steroids.

並列關鍵字

rituximab ； lymphoma ； pulmonary disease ； interstitial pneumonitis ； steroid