Delayed pulmonary toxicity syndrome

Acute pulmonary edema Diffuse alveolar hemorrhage Periengraftment respiratory distress syndrome Bronchiolitis obliterans syndrome Bronchiolitis obliterans organizing pneumonia Idiopathic pulmonary syndrome Delayed pulmonary toxicity syndrome Pulmonary cytolytic thrombi Pulmonary veno-occlusive disease Progressive pulmonary fibrosis Pulmonary hypertension Hepatopuhnonary S3mdrome Pulmonary alveolar proteinosis Eosinophilic pneumonia... 

Wilczynski SW, Erasmus JJ, Petros WP, et al. Delayed pulmonary toxicity syndrome following high-dose chemotherapy and bone marrow transplantation for breast cancer. Am J Respir Grit Care Med 1998 157(2) 565-573. 

Myelosuppression neutropenia, thrombocytopenia may be more severe with infusions >1 hour myelosuppression may necessitate dose reduction and/or delay in therapy flu-like syndrome fever, myalgias rash typically erythematous, pruritic, starts 48-72 hours after dose elevations in liver transaminases low emetogenic potential rare pulmonary toxicity dyspnea, bronchospasm radiation-recall reactions... 

Myelosuppression may be delayed and prolonged (up to 8 weeks) mucositis moderately emetogenic extravasation severe vesicant pulmonary toxicity pneumonitis, fibrosis (worse with concurrent vincristine or vinblastine) hemolytic anemia and uremic syndrome... 

Pulmonary edema noted after a toxic inhalant exposure should be treated similarly to adult respiratory distress syndrome (ARDS) or noncardiac pulmonary edema. The early application of PEEP is desirable, possibly delaying or reducing the severity of pulmonary edema. Diuretics are of limited value however, if diuretics are used, it is use-... 

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