Type: nucleoside analog
Patterns of injury:
(1) diffuse alveolar damage a
(2) alveolar hemorrhage
(3) noncardiogenic pulmonary edema, including the capillary leak syndrome
The patient may present with dyspnea, cough, fatigue, malaise. Some patients develop acute respiratory distress syndrome (ARDS).
Risk factors for lung toxicity:
(1) pre-existing lung disease
(2) radiation therapy to the chest
(3) concomitant therapy: paclitaxel, docetaxel, ifosfamide, erlotinib
(4) concomitant therapy with granulocyte colony stimulating (GCS) factor
(5) continued gemcitabine therapy after onset of pulmonary symptoms
A patient with a past history of radiation therapy may develop a recall syndrome with dry cough and dyspnea upon exposure to gemcitabine.
