Procarbazine pulmonary toxicity

Mahmood T, Mudad R. Pulmonary toxicity secondary to procarbazine. Am J Clin Oncol 2002 25(2) 187-8. 

Answer A. It can help to know which anticancer drugs are cell-cycle specific and which have characteristic toxicities. Bleomycin fits both categories acting mainly in G2, it is cell cycle specific and is distinctive for causing mucocutaneous reactions and pulmonary dysfunction. Busulfan and procarbazine may also cause pulmonary toxicity, but neither drug is cell-cycle specific. 

Procarbazine Alkylating agent Hodgkin s (MOPP) BMS, pulmonary toxicity, hemolysis, neurotoxicity, leukemogenic... 

The anticancer drug most commonly associated with pulmonary toxicity is bleomycin. If pulmonary dysfunction with infiltration developed, the drug would be discontinued. High-dose steroids and empiric antibiotic therapy would also be indicated. Note that procarbazine (not listed), used in the MOPP regimen for Hodgkin s lymphoma, may also cause cough and pleural effusions. The answer is (A). 

Rarely, azathioprine and its major metabohte 6-mercaptopurine have been reported to produce an acute restrictive lung disease. Procarbazine, a methylhydrazine associated more commonly with Loef-fler s syndrome, rarely has been associated with pulmonary fibrosis. The vinca alkaloids vinblastine and vindesine have been reported to produce severe respiratory toxicity in association with mitomycin. The incidence with the combination is 39% and may represent a true synergistic effect between these agents. ... 

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