Fatal pulmonary toxic effects of lomustine.

Lomustine (1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea; CCNU) is a synthetic orally active nitrosourea marketed in the past few years for the chemotherapy of carcinoma, particularly of the brain. The major toxic effects are bone marrow suppression with leucopenia and thrombocytopenia and gastrointestinal effects with nausea and vomiting. Progressive lung changes resulting from cytotoxic drugs such as busulphan and bleomycin are now well recognised and recent reports have documented the pulmonary toxicity that may result from the use of BCNU (bischloroethyl nitrosourea).' 2 I report a case in which lomustine treatment was followed by fatal pulmonary changes.