DURHAM, N.C. - Researchers at Duke University Medical Center have identified a lung condition that if not treated promptly can limit therapy choices for women undergoing high-dose chemotherapy and bone marrow transplantation (BMT) for breast cancer.

The Duke team followed 45 women and found side effects to the lungs that were different and less severe than any reported previously in the medical literature. The disorder, termed delayed pulmonary toxicity syndrome (DPTS) by the Duke researchers, can be successfully treated by inexpensive corticosteroids (prednisone) if diagnosed early in the course of a woman's cancer treatment.

About 64 percent of the women in the Duke study demonstrated symptoms of DPTS, with no reported mortality, and those treated with steroids saw 17 percent improvement in pulmonary function.

The results of the Duke study, led by pulmonologist Rodney Folz, were published Thursday (Feb. 19) in the February issue of the American Journal of Respiratory and Critical Care Medicine. The research was supported by two National Institutes of Health grants.

High-dose chemotherapy coupled with BMT is becoming an increasingly important way of treating breast cancer. Chemotherapy kills dividing cells, particularly cancer cells and immune system cells. To avoid killing immune cells, physicians remove the bone marrow that produces them before beginning treatment.

After the course of chemotherapy is completed, the bone marrow cells are re-infused into the patient (autologous transplant), where they grow and create a new immune system. In some cases, women receive bone marrow from donors (allogeneic transplant).

"We have long known that the higher the dose of chemotherapy, the better the cancer kill rate is," Folz said. "In patients receiving this treatment for breast cancer, what limits
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
18-Feb-1998