Daunorubicin Treatment of Methotrexate Pneumonia

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Abstract
To the Editor.— A report in The Journal (207:923-928, 1969) suggested a new type of toxic reaction during methotrexate maintenance therapy. This was a frequently occurring pneumonia in 38 of 93 children receiving intermittent methotrexate therapy. In the same year, Clarysse et al later described the disease in seven cases (209:1861, 1969) and defined it as a severe but self-limited respiratory tract illness characterized by fever, cough, dyspnea, cyanosis, and bilateral pulmonary infiltrates. They suggested that it was due to a hypersensitivity to methotrexate. Schwartz and Kajani (210:1927, 1969) reported two cases in which high dose prednisone treatment resulted in prompt recovery. We should like to report here three cases in whom daunorubicin (daunomycin, rubidomycin) seems to have had beneficial effects. In the first case in August 1968, we assumed that the pulmonary symptoms might be due to a leukemic localization, and treated this patient with daunomycin.

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