To the editor: Orwoll and others (1) have reported in the September issue on the association of mitomycin with interstitial pneumonia. In the past 2 years we have seen two patients who died with unexplained severe interstitial pneumonitis after receiving mitomycin chemotherapy.
The first case was that of a 53-year-old man with adenocarcinoma of the pancreas who received weekly mitomycin, 5-fluorouracil, and cytosine arabinoside during an 18-week period for a total mitomycin dose of 50 mg. He developed progressive dyspnea leading to death within 3 weeks after a short preterminal period of progressive dyspnea. At autopsy, alveolar septal thickening and