Bleomycin lung toxicity
Updates to Article Attributes
Bleomycin lung toxicity is an uncommon but recognised complication that can occur with the chemotherapeutic drug Bleomycinbleomycin.
Pathology
Bleomycin
Bleomycin is an antitumour antibiotic which was initallyinitially isolated from a strain of Streptomyces verticillus in 1966. It is commonly used (either alone or in combination with other chemotherapeutic agents) in the treatment of squamous cell carcinomas (of the head and neck, cervix, and vagina), testicular carcinomascancer, and Hodgkin lymphoma.
Epidemiology
Bleomycin-induced lung injury usually occurs in 3-18% of treated patients (this figure will vary dependent on detection method used), although there is a marked increased risk if the total cumulative dose is more than 450 units.
The risk of developing lung injury is increased in the elderly and in patients receiving oxygen therapy, with a history of prior thoracic irradiation, or in whom therapy is re-instituted within 6 months of discontinuation.
Radiographic features
CT
On HRCT chest it can manifest in several patterns Itwhichthat include:
- diffuse alveolar damage
- pulmonary fibrosis
- organising pneumonia pattern
- NSIP pattern
-
bronchiolitis obliterans organising pneumonia pattern
- may present as nodules which
couldrange from 5 mm to 3 cm in diameter 1 - are usually subpleural in location, and can be sharply or poorly marginated
- may present as nodules which
Treatment and prognosis
The prognosis is poor, with most patients dying of respiratory failure within 3 months of onset of symptoms.
See also
-<p><strong>Bleomycin lung toxicity </strong>is an uncommon but recognised complication that can occur with the chemotherapeutic drug Bleomycin.</p><h4>Pathology</h4><h6>Bleomycin</h6><p>Bleomycin is an antitumour antibiotic which was initally isolated from a strain of <em>Streptomyces verticillus</em> in 1966. It is commonly used (either alone or in combination with other chemotherapeutic agents) in the treatment of squamous cell carcinomas (of the head and neck, cervix, and vagina), testicular carcinomas, and Hodgkin lymphoma.</p><h4>Epidemiology</h4><p>Bleomycin-induced lung injury usually occurs in 3-18% of treated patients (this figure will vary dependent on detection method used), although there is a marked increased risk if the total cumulative dose is more than 450 units.</p><p>The risk of developing lung injury is increased in the elderly and in patients receiving oxygen therapy, with a history of prior thoracic irradiation, or in whom therapy is re-instituted within 6 months of discontinuation.</p><h4>Radiographic features</h4><h5>HRCT chest</h5><p>It can manifest in several patterns which include:</p><ul>- +<p><strong>Bleomycin lung toxicity </strong>is an uncommon but recognised complication that can occur with the chemotherapeutic drug bleomycin.</p><h4>Pathology</h4><h6>Bleomycin</h6><p>Bleomycin is an antitumour antibiotic which was initially isolated from a strain of <em>Streptomyces verticillus</em> in 1966. It is commonly used (either alone or in combination with other chemotherapeutic agents) in the treatment of squamous cell carcinomas (of the head and neck, cervix, and vagina), testicular cancer, and Hodgkin lymphoma.</p><h4>Epidemiology</h4><p>Bleomycin-induced lung injury usually occurs in 3-18% of treated patients (this figure will vary dependent on detection method used), although there is a marked increased risk if the total cumulative dose is more than 450 units.</p><p>The risk of developing lung injury is increased in the elderly and in patients receiving oxygen therapy, with a history of prior thoracic irradiation, or in whom therapy is re-instituted within 6 months of discontinuation.</p><h4>Radiographic features</h4><h5>CT</h5><p>On HRCT chest it can manifest in several patterns that include:</p><ul>
-<li>may present as nodules which could range from 5 mm to 3 cm in diameter <sup>1</sup>- +<li>may present as nodules which range from 5 mm to 3 cm in diameter <sup>1</sup>
-</ul><h4>Treatment and prognosis</h4><p>The prognosis is poor, with most patients dying of respiratory failure within 3 months of onset of symptoms.</p><h4>See also</h4><ul><li><a href="/articles/drug-induced-lung-disease">drug induced lung disease</a></li></ul>- +</ul><h4>Treatment and prognosis</h4><p>The prognosis is poor, with most patients dying of respiratory failure within 3 months of onset of symptoms.</p>