Bortezomib therapy‐related lung disease in Japanese patients with multiple myeloma: Incidence,mortality and clinical characterization |
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Authors: | Kazutake Yoshizawa Harumi Y. Mukai Michiko Miyazawa Makiko Miyao Yoshimasa Ogawa Kazuma Ohyashiki Takao Katoh Masahiko Kusumoto Akihiko Gemma Fumikazu Sakai Yukihiko Sugiyama Kiyohiko Hatake Yuh Fukuda Shoji Kudoh |
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Affiliation: | 1. Division of Medical Affairs, Janssen Pharmaceutical K.K., , Tokyo, Japan;2. Division of Research and Development, Janssen Pharmaceutical K.K., , Tokyo, Japan;3. First Department of Internal Medicine, Tokyo Medical University, , Tokyo, Japan;4. Division of Cardiology, Hepatology, Geriatrics and Integrated Medicine, Department of Internal Medicine, Nippon Medical School, , Tokyo, Japan;5. Division of Diagnostic Radiology, National Cancer Center Hospital, , Tokyo, Japan;6. Division of Pulmonary Medicine, Infectious Disease and Oncology, Department of Internal Medicine, Nippon Medical School, , Tokyo, Japan;7. Department of Radiology, Saitama Medical University International Medical Center, , Hidaka‐shi, Japan;8. Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, , Shimotsuke‐shi, Japan;9. Department of Hematology Oncology, Cancer Institute Hospital, , Tokyo, Japan;10. Department of Analytic Human Pathology, Nippon Medical School, , Tokyo, Japan;11. Double‐Barred Cross Hospital Japan Anti‐Tuberculosis Association, , Tokyo, Japan |
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Abstract: | Because of the potentially high mortality rate (6.5%) associated with bortezomib‐induced lung disease (BILD) in Japanese patients with relapsed or refractory multiple myeloma, we evaluated the incidence, mortality and clinical features of BILD in a Japanese 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 Japan 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 Japan. This study describes the radiographic pattern and clinical characterization of BILD in the Japanese population. The RMAP seemed clinically effective in minimizing the BILD risk among our Japanese population. |
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Keywords: | Bortezomib lung disease mortality multiple myeloma proteasome inhibitors |
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