Abstract
Rituximab, a chimeric anti-CD20 monoclonal antibody, is commonly being used to treat indolent and aggressive B-cell non-Hodgkin's lymphoma. Rituximab is considered a relatively safe drug, but recently, severe and fatal adverse effects related to this drug have been reported. In this regard, we report an 80-year-old patient with follicular grade 3 non-Hodgkin's lymphoma who developed a fatal interstitial pneumonitis related to treatment with a rituximab/CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) regimen. The pneumonitis was diagnosed on a routine midtreatment positron emission tomography/computed tomography scan when the patient was almost asymptomatic. Pulmonary deterioration occurred as the treatment with rituximab/CHOP was continued. In this article, we also review the literature on rituximab-associated pneumonitis, and we discuss the differential diagnosis with cyclophosphamide-induced lung injury.
MeSH terms
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Aged
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Aged, 80 and over
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Biopsy, Needle
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Cyclophosphamide / adverse effects
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Cyclophosphamide / therapeutic use
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Disease Progression
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Dose-Response Relationship, Drug
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Doxorubicin / adverse effects
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Doxorubicin / therapeutic use
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Drug Administration Schedule
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Fatal Outcome
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Humans
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Immunohistochemistry
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Lung Diseases, Interstitial / chemically induced*
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Lung Diseases, Interstitial / physiopathology
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Lymphoma, Non-Hodgkin / drug therapy*
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Lymphoma, Non-Hodgkin / pathology
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Male
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Neoplasm Staging
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Prednisolone / adverse effects
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Prednisolone / therapeutic use
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Radiography, Thoracic
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Risk Assessment
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Rituximab
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Tomography, X-Ray Computed
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Vincristine / adverse effects
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Vincristine / therapeutic use
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisolone