Analysis of clinical characteristics of lung injury related to tyrosine kinase inhibitors
10.3760/cma.j.cn114015-20220503-00379
- VernacularTitle:酪氨酸激酶抑制剂相关肺损伤临床特征分析
- Author:
Ruohan YE
1
;
Yaozhou WU
1
;
Li WEI
1
;
Pengjiu YU
1
Author Information
1. 广州医科大学附属第一医院药学部，广州 510120
- Publication Type:Journal Article
- Keywords:
Lung diseases;
Receptor, epidermal growth factor;
Tyrosine kinase inhibitors;
Drug-related side effect and adverse reactions
- From:
Adverse Drug Reactions Journal
2023;25(7):413-418
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of lung injury related to tyrosine kinase inhibitors (TKIs).Methods:The electronic medical records of patients with lung injury who received TKIs treatment in the First Affiliated Hospital of Guangzhou Medical University from August 2014 to May 2019 were collected by searching the Hospital Information System and retrospectively analyzed. The data extracted from the medical records included the patient′s gender, age, primary disease, clinical manifestation, TKIs medication, time from TKIs medication to occurrence of lung injury, laboratory test and imaging examination results, treatment and outcome, etc.Results:A total of 20 patients were enrolled in the study, including 10 males and 10 females. Their ages were from 32 to 75 years, with a median age of 60 years. The primary diseases were lung adenocarcinoma in 16 cases, chronic myeloid leukemia in 3 cases, and small intestinal stromal cell tumor in 1 case; 6 patients had smoking history; the clinical manifestations were cough in 19 patients, shortness of breath after activity in 17 patients, expectoration in 12 patients, chest pain and fever in 5 patients each, fatigue in 1 patient, and hypoxemia in 13 patients. Among the 20 patients, 17 were treated with epidermal growth factor receptor TKI and 3 with imatinib. The time of occurrence of lung injury was 2 days to 2 years after medication, with a median time of 1 month. Laboratory tests showed that the level of C-reactive protein increased in 15 patients, the level of Krebs von den Lungren-6 increased in 11 patients, procalcitonin increased in 11 patients, erythrocyte sedimentation rate increased in 10 patients, and lactate dehydrogenase increased in 6 patients; partial pressure of oxygen decreased in 13 patients, oxygen saturation decreased in 11 patients, partial pressure of carbon dioxide decreased in 7 patients, and partial pressure of carbon dioxide increased in 5 patients. All 20 patients underwent chest CT examination, showing patchy ground glass shadow in 18 patients, pleural effusion in 8 patients, nodules in 6 patients, interlobular septal thickening in 3 patients, grid fuzzy shadow in 2 patients, and pneumothorax in 1 patient. After the occurrence of lung injury, all patients stopped TKIs, 18 received glucocorticoid and symptomatic treatments, 4 were cured, 9 were improved, 4 had poor efficacy, and 1 died; 2 patients were improved only after anti-infection and symptomatic treatments.Conclusions:The clinical manifestations of lung injury related to TKIs are nonspecific, and the time from medication to occurrence of adverse reactions varies. After drug withdrawal and receiving glucocorticoid and symptomatic treatments, the prognosis in most patients is good. However, the occurrence of adverse consequences should be paid attention to.
