Metastatic interstitial pneumonitis after autologous bone marrow transplantation: A consequence of reinjection of malignant cells?

✍ Scribed by Philippe Glorieux; Eric Bouffet; Irène Philip; Pierre Biron; Laurent Holzapfel; Daniel Floret; Raymonds Bouvier; Danielle Vitrey; Ross Pinkerton; Maud Brunat-Mentigny; Thierry Philip

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 435 KB
• Volume: 58
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19861101)58:9<2136::aid-cncr2820580929>3.0.co;2-j

✦ Synopsis

Two cases of fatal interstitial pneumonitis developing after an autologous bone marrow transplantation are described. In both cases the autopsy revealed diffuse malignant pulmonary involvement. The first case involved a 4-year-old boy who had a Burkitt's lymphoma; the second case involved a 4-year-old girl with a neuroblastoma. The authors postulate that in these cases, the clinical picture may have been related to reinfusion of malignant cells.

Cancer 58:2136-2139.1986.

NTERSTITIAL PNEUMONITIS is a common and often fatal I complication of allogenic bone marrow transplantation (BMT.), a problem that has been recently reviewed by several authors. 1-3 The incidence of interstitial pneumonitis after autologous BMT. is less well-known, but in the absence of graft-versus-host disease (GVHD.), risk factors are lower and seem to be comparable to those after syngeneic BMT.4 In this setting, interstitial pneumonitis is most often idiopathic and usually related to toxicity from chemotherapy and i r r a d i a t i ~n . ~, ~

In addition to the extramedullary toxicity of "massive therapy" regimens, a potential problem in autologous BMT. is the presence of residual malignant cells in the reinfused bone marrow.

To our knowledge, an isolated relapse presenting as interstitial pneumonitis after an autologous BMT. has not been previously reported. The two patients, described in this report, developed fatal interstitial pulmonary disease after autologous BMT, and the autopsies revealed diffuse malignant pulmonary involvement without any other metastatic site.