Active lung fibrosis up to 17 years after chemotherapy with carmustine (BCNU) in childhood

Article Abstract:

Carmustine (BCNU) is a chemotherapy drug that is used against brain tumors, malignant melanoma, lymphomas, and other tumors. A side effect of carmustine therapy is pulmonary fibrosis, the formation of scar tissue in the lungs. The proportion of patients treated with carmustine that develop lung fibrosis has been reported from 1 to 30 percent. A study was conducted to investigate how long after carmustine therapy a patient may develop lung fibrosis as a side effect. A group of 17 children who survived brain tumors and received treatment with carmustine between 1972 and 1976 was studied. Of the 17, six had died from lung fibrosis; two children died within three years of the carmustine treatment, and four died between 8 and 13 years after chemotherapy. Of the 11 children who did not die of either the brain tumor or lung fibrosis, eight were studied intensively for an average of 14 years after carmustine therapy. Imaging studies of their lungs (chest X-rays and computed tomographic scans) showed that six of the eight patients had fibrotic changes. Spirometry testing, which measures the air capacity of the lungs, showed that the vital capacity of the lungs was, on average, only 54 percent of normal. Other tests found evidence of fibrosis as well. Four of the patients reported they had a cough, shortness of breath, or both. It was concluded that children who are given carmustine may have lung fibrosis, which can exist without symptoms for many years, but become symptomatic at any time, sometimes many years after the chemotherapy. Carmustine continues to be used for many cancer patients, and it is suggested that the risks and benefits of the drug be carefully weighed, as the probability of developing chronic lung fibrosis is high. Alternative drugs should be chosen instead whenever possible. Patients who were given carmustine should be monitored carefully for fibrosis over the long term. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer in children, Childhood cancer, Pulmonary fibrosis, Carmustine

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Oral versus intravenous empirical antimicrobial therapy for fever in patients with granulocytopenia who are receiving cancer chemotherapy

Article Abstract:

Some cancer patients with granulocytopenia caused by chemotherapy may benefit from oral antibiotics rather than intravenous antibiotics. Granulocytopenia is a decrease in white blood cells, which predisposes cancer patients to infection. In a study of 353 cancer patients randomly assigned to oral or intravenous antibiotics, over 80% of the patients in both groups were successfully treated. Patients at low risk of infection could be treated with oral antibiotics on an outpatient basis, which would reduce the cost of treatment.

Statistical Data Included, Antibiotics, Prevention, Bacterial infections, Dosage and administration, Granulocytopenia

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Potential options for preservation of fertility in women

Article Abstract:

The ability to preserve fertility with various methods has become a key issue for women especially cancer patients. The progressive loss of oocytes from fetal life through menopause is a normal process and so oocytes that are lost cannot be replaced, identifying women who are at risk for early ovarian failure, particularly among those with cancer.

United Kingdom, Women, Risk factors, Women's health, Menopause, Fertility, Human, Human fertility

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