Pleural Effusion FCR

[Guest guest]

Some of you already know about this, but I thought I would

post it to the group for our archives since it is not in the

medical literature on the topic of adverse events associated

with FCR.

A pleural effusion is a collection of fluid in the pleural

lining of the lungs. It makes it hard to breathe, which can

be very scary. An effusion can appear on the left or right

lung, or both.

They are more commonly seen in lymphomas, but are also seen

in CLL/SLL. It is addressed by draining the pleural space.

The procedure is called a therapeutic Thorenthesis.

If you want additional information about the topic, the

Cleveland Clinic has an excellent short article which can be

found via Google.

I experienced a pleural effusion as the result of FCR. My

local hem/onc did not recognise the unusual symptoms

reported over a week after the first infusion, which

included spiking fevers (102-105 one minute, and an hour

later less than normal).

At the start of the second week, I checked myself into the

ER and stayed in the hospital for 5 days while they looked

for an infection, but never found one. After being

admitted, a small effusion appeared on the left lung but

never got big enough to be drained. The effusion on the

right lung was drained twice.

The same thing happened after the second round of FCR, but

this time I knew what to look out for and had the effusion

drained as an out patient. I continued to work during the

very annoying spiking fevers.

At the third round, F & C were reduced because of low counts

and the effusions slowly began to disappear and the spiking

fevers were non-existent. By the 5th round, the small left

effusion and the large one on the right lung were completely

gone.

Take home message: Despite the lack of documentation in

medical literature, infusion related reactions can happen

(i.e. spiking fevers of unknown origin, and pleural

effusions).

Pleural effusions associated with malignant conditions don't

go away. I sat next to a woman in the infusion center who

had end stage lung cancer. She had hers drained every 3rd

day, and passed away shortly after her doctor set her up to

personally drain it at home.

Read more about it on Google, Cleveland Clinic.

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Mod's note from - links to the article:

http://my.clevelandclinic.org/disorders/pleural_effusion/ts_overview.aspx

or http://tinyurl.com/3yeukrj