Chest
Volume 110, Issue 1, July 1996, Pages 289-292
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Selected Reports
Pulmonary Infiltrates Following Administration of Paclitaxel

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The clinical spectrum of hypersensitivity reactions reported with paclitaxel has not included the occurrence of pulmonary infiltrates. This report describes three patients who developed transient pulmonary infiltrates after receiving paclitaxel. These infiltrates were noted 2 days to 2 weeks after administration of paclitaxel. The infiltrates resolved spontaneously in all the patients but one of them did receive steroid therapy. This syndrome of transient pulmonary infiltrates did not reoccur in the two patients who were rechallenged with paclitaxel. Physicians should be made aware of this unique occurrence during the course of treatment with paclitaxel.

Section snippets

CASE 1

A 66-year-old white woman with a 40 pack-year history of cigarette smoking presented with recurrent non-small cell lung cancer (NSCLC) in the left lung. Multiple tumor nodules were noted about 2 years after initial surgery for stage I disease. A regimen of carboplatin and paclitaxel combination for metastatic disease was begun. Carboplatin dose was given according to the Calvert et al4 formula with a target area under the time concentration curve (AUC) of 9 mg/mL-min. Paclitaxel was given at

DISCUSSION

Hypersensitivity reactions previously reported with paclitaxel have not been associated with the occurrence of pulmonary infiltrates.1,3 Chemotherapeutic agents that are known to cause pulmonary infiltrates as a part of the hypersensitivity reactions are bleomycin, methotrexate, and procarbazine.5,6 These reactions are often seen within hours to a few days after drug administration. Predominant airway involvement causes an asthma-like syndrome, and patchy eosinophilic infiltrates are seen with

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