Pulmonary, Pleural, and Thoracic Changes Complicating Chemotherapy

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Abstract
Chronic respiratory failure slowly developed in 2 pediatric patients following long-term cyclophosphamide therapy for lymphocytic malignancy. One patient survived 12 yr after acute lymphocytic leukemia was diagnosed but died of respiratory failure at age 16 still in initial remission. The other, a 12 yr survivor of Hodgkin disease, has progressive deterioration of pulmonary function. Each patient received cyclophosphamide (less than 70 g) during the initial years of the disease. Autopsy of the 1st patient and lung biopsy in the 2nd revealed severe pulmonary fibrosis. There was loss of compliance and a dramatic change in the shape of the thorax which produced a markedly reduced anteroposterior diameter in both patients, and recurrent pneumothoraces in one.

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