Author/Authors :
Bauer, Torsten T. Department of Pneumology - Lungenklinik Heckeshorn - HELIOS Klinikum Emil von Behring - Berlin, Germany , Jungmann, Sven Department of Pneumology - Lungenklinik Heckeshorn - HELIOS Klinikum Emil von Behring - Berlin, Germany , Sch ̈onfeld, Nicolas Department of Pneumology - Lungenklinik Heckeshorn - HELIOS Klinikum Emil von Behring - Berlin, Germany , Blum, Torsten-Gerriet Department of Pneumology - Lungenklinik Heckeshorn - HELIOS Klinikum Emil von Behring - Berlin, Germany , Boch, Christian Department of Pneumology - Lungenklinik Heckeshorn - HELIOS Klinikum Emil von Behring - Berlin, Germany , Ludwig, Wolf-Dieter Drug Commission of the German Medical Association - Herbert-Lewin-Platz 1 - Berlin, Germany , Großwendt, Claudia Department of Radiology - HELIOS Klinikum Emil von Behring - Berlin, Germany , Rehbock, Beate Diagnostic Radiology -oracic Imaging - Bismarckstr 45-47 - Berlin, Germany , Griff, Sergej Institute of Pathology - HELIOS Klinikum Emil von Behring - Berlin, Germany , Schmittel, Alexander Onkologie Seestrasse - Berlin, Germany
Abstract :
We present a 74-year-old male with nonspeci1c interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle celllymphoma.Previously,thepatienthadreceivedsixcyclesofbendamustineandrituximabandsixcyclesofR-CHOP,followedbyrituximab maintenance therapy. Respiratory tract complications of ibrutinib other than infectious pneumonia have not beenmentionedinlargertrials,butindividualcasereportshintedtoapossibleassociationwiththedevelopmentofpneumonitis.Inourpatient,theonsetofalveolitisthatprogressedtowardsNSIPtogetherwiththeonsetofibrutinibtreatmentsuggestscausality.Oneweek after ibrutinib was discontinued, nasal symptoms resolved 1rst. A follow-up CT showed a reduction in the reticularhyperdensities and ground-glass opacities, suggestive of restitution of the lung disease. To our knowledge, this is the 1rst caseshowing a strong link between ibrutinib and interstitial lung disease, strengthening a previous report on subacute pneumonitis.Our 1ndings have clinical implications because pulmonary side effects were reversible at this early stage. We, therefore, suggestclose monitoring for respiratory side effects in patients receiving ibrutinib.
Keywords :
Patient , Non-Hodgkin Lymphoma , Nonspecific Interstitial Pneumonia , Ibrutinib Therapy , NSIP
