Home
Up
Contacts
Blood Disorders
Transplantation
Blood Products
Bone Marrow
Links
PVT

Perth Haematology :: Dr Steven Ward

Bleomycin Pulmonary Toxicity

 

Bleomycin Pulmonary Toxicity

bullet

Interstitial pneumonitis then fibrosis

 

bullet

Increased incidence:

bullet

Age > 40 years

bullet

Renal impairment (Creat > ULN; CCl <70mL/min)

bullet

Cumulative dose of Bleomyicn >300U

bullet

Stage IV disease

 

bullet

 Monitoring:

bullet

 No published guidelines

bullet

Routine pulmonary Function Tests may fail to detect toxicity

bullet

Perhaps a reduction in the mean DLCO is most useful (but not very discriminant)

 

bullet

Bleomycin Elimination:

bullet

Renal excretion 70% at 24h

bullet

 CCl > 35mL/min had similar bleomycin terminal half life; below this shows an exponential increase in half-life.

 

Summary:

bullet

 Omit Bleomycin if CCl <35mL/min

bullet

Use with caution if > 40 years; CCl <80mL/min

bullet

Monitor by clinical signs and DLCO