Severe alveolar proteinosis following chemotherapy for acute myeloid leukemia in a lung allograft recipient

J Thorac Imaging. 2001 Oct;16(4):307-9. doi: 10.1097/00005382-200110000-00014.


A 64-year-old man was diagnosed with acute myeloid leukemia (AML) 5 years following single lung transplantation performed for severe pulmonary hypertension from scleroderma. Chemotherapy for treatment of AML with fludarabine, cytosine arabinoside, G-CSF (FLAG) regimen was initiated. Despite intensive antibiotic treatment for a presumptive diagnosis of bacterial pneumonia, the patient developed acute respiratory failure and died before a complete cycle of chemotherapy could be administered. At autopsy, both native and allograft lungs showed widespread alveolar proteinosis that was determined as the main cause of acute respiratory failure. Alveolar proteinosis, a potentially treatable disease, should be considered in the radiologic differential diagnosis of diffuse lung disease in this clinical setting.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cytarabine / adverse effects*
  • Diagnosis, Differential
  • Fatal Outcome
  • Granulocyte Colony-Stimulating Factor / adverse effects*
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy*
  • Male
  • Middle Aged
  • Pulmonary Alveolar Proteinosis / diagnostic imaging*
  • Pulmonary Alveolar Proteinosis / etiology*
  • Tomography, X-Ray Computed
  • Vidarabine / adverse effects*
  • Vidarabine / analogs & derivatives


  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Vidarabine

Supplementary concepts

  • FLAG protocol