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We read with great interest the article by Perros et al,1 which reported mitomycin C (MMC)–induced pulmonary veno-occlusive disease (PVOD) in patients displaying anal squamous cancer and in a rat preclinical model.We would like to share our experience with 2 more patients with pulmonary hypertension related to MMC exposure who did not show radiological evidence of PVOD. It concerns a 59-year-old man with an anal carcinoma and a 53-year-old woman with an anorectal spinocellular carcinoma. Both were treated by radiochemotherapy (MMC plus 5-fluoruracil) and developed dyspnea on exertion within 4 years and 1 year. Echocardiogram showed increased systolic pulmonary arterial pressure, right ventricular dilatation …

Letter by Belge et al Regarding Article, “Mitomycin-Induced Pulmonary Veno-Occlusive Disease: Evidence From Human Disease and Animal Models”