INTERSTITIAL PNEUMONITIS POSSIBLY DUE TO MITOXANTRONE

A 41-year-old patient with chronic myelogenous leukemia in the acceler ated phase was treated with mitoxantrone. She developed pyrexia 7 days after receiving the third administration of mitoxantrone. After 3 mor e days, she experienced dry cough and dyspnea. Bilateral fine crackles were audible, but no signs of heart failure were found. A chest X-ray film revealed diffuse reticulogranular infiltrates bilaterally. An in crease in the prednisolone dosage led to an improvement. Specimens of the bronchoalveolar lavage revealed an increase in CD4(-)/CD8(-) lymph ocytes. The peripheral lymphocytes also expressed neither CD4 nor CD8. Specimens of a transbronchial lung biopsy disclosed thickening of the alveolar wall with infiltration of lymphoid cells.