Baba Keisuke, Matsubara Yasuo, Hirata Yoshihiro, Ota Yasunori, Takahashi Satoshi, Boku Narikazu
Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Department of Diagnostic Pathology, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Front Oncol. 2023 Jun 16;13:1215789. doi: 10.3389/fonc.2023.1215789. eCollection 2023.
Two mechanisms of drug-induced interstitial lung disease (DILD) have been reported: 1) direct injury of lung epithelial cells and/or endothelial cells in lung capillaries by the drug and/or its metabolites and 2) hypersensitivity reactions. In both mechanisms, immune reactions such as cytokine and T cell activation are involved in DILD. While past and present lung diseases and accumulative lung damage due to smoking and radiation are risk factors for DILD, the association between the immune status of the host and DILD is not well known. Herein, we report a case of advanced colorectal cancer with a history of allogeneic bone marrow transplantation for aplastic anemia more than 30 years prior, in which DILD occurred early after irinotecan-containing chemotherapy. Bone marrow transplantation might be a potential risk factor for DILD.
药物性间质性肺病（DILD）的发病机制有两种：1）药物及其代谢产物对肺上皮细胞和/或肺毛细血管内皮细胞的直接损伤；2）超敏反应。在这两种机制中，细胞因子和T细胞活化等免疫反应均参与了DILD的发生。虽然既往和目前的肺部疾病以及吸烟和辐射导致的累积性肺损伤是DILD的危险因素，但宿主免疫状态与DILD之间的关联尚不清楚。在此，我们报告一例晚期结直肠癌患者，该患者30多年前曾因再生障碍性贫血接受异基因骨髓移植，在含伊立替康的化疗后早期发生了DILD。骨髓移植可能是DILD的一个潜在危险因素。
