Open AccessBortezomib therapy‐related lung disease in J apanese patients with multiple myeloma: Incidence, mortality and clinical characterization
Author(s) -
Yoshizawa Kazutake,
Mukai Harumi Y.,
Miyazawa Michiko,
Miyao Makiko,
Ogawa Yoshimasa,
Ohyashiki Kazuma,
Katoh Takao,
Kusumoto Masahiko,
Gemma Akihiko,
Sakai Fumikazu,
Sugiyama Yukihiko,
Hatake Kiyohiko,
Fukuda Yuh,
Kudoh Shoji
Publication year - 2014
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12335
Subject(s) - medicine , bortezomib , multiple myeloma , incidence (geometry) , population , mortality rate , surgery , physics , environmental health , optics
Because of the potentially high mortality rate (6.5%) associated with bortezomib‐induced lung disease ( BILD ) in J apanese patients with relapsed or refractory multiple myeloma, we evaluated the incidence, mortality and clinical features of BILD in a J apanese population. This study was conducted under the Risk Minimization Action Plan ( RMAP ), which was collaboratively developed by the pharmaceutical industry and public health authority. The RMAP consisted of an intensive dissemination of risk information and a recommended countermeasure to health‐care professionals. All patients treated with bortezomib were consecutively registered in the study within 1 year and monitored for emerging BILD . Of the 1010 patients registered, 45 (4.5%) developed BILD , 5 (0.50%) of whom had fatal cases. The median time to BILD onset from the first bortezomib dose was 14.5 days, and most of the patients responded well to corticosteroid therapy. A retrospective review by the Lung Injury Medical Expert Panel revealed that the types with capillary leak syndrome and hypoxia without infiltrative shadows were uniquely and frequently observed in patients with BILD compared with those with conditions associated with other molecular‐targeted anticancer drugs. The incidence rate of BILD in J apan remains high compared with that reported in other countries, but the incidence and mortality rates are lower than expected before the introduction of bortezomib in J apan. This study describes the radiographic pattern and clinical characterization of BILD in the J apanese population. The RMAP seemed clinically effective in minimizing the BILD risk among our J apanese population.