How does bleomycin cause pulmonary toxicity?
The lung injury seen following bleomycin comprises an interstitial oedema with an influx of inflammatory and immune cells. This may lead to the development of pulmonary fibrosis, characterized by enhanced production and deposition of collagen and other matrix components.
Does bleomycin cause lung damage?
Bleomycin is the chemotherapy drug most commonly associated with lung damage. The reported incidence ranges from 3% to 40%.
What is bleomycin-induced pneumonitis?
The mechanism of bleomycin-induced pneumonitis (BIP) involves oxidative damage, relative deficiency of the deactivating enzyme bleomycin hydrolase, genetic susceptibility, and the elaboration of inflammatory cytokines. Ultimately, BIP can progress to lung fibrosis.
Is bleomycin toxicity reversible?
The exact incidence and prognosis of bleomycin-pneumonitis is unresolved. Although bleomycin pulmonary toxicity is thought to be dose-related, recent reports have emphasized severe reactions at low doses. Furthermore, severe pulmonary toxicity has been suggested to be progressive, irreversible, and ultimately, fatal.
Can you have oxygen after bleomycin?
Patients who have been treated with bleomycin should not receive high concentrations of oxygen during subsequent general anaesthesia as this can lead to respiratory failure [1,2].
Can I have oxygen after bleomycin?
Is pulmonary toxicity reversible?
One well known serious side effect of amiodarone is pulmonary toxicity which can be acute, sub-acute, or chronic and can be irreversible and fatal.
What is bleomycin toxicity?
Bleomycin is an antineoplastic agent with potential for producing pulmonary toxicity, attributed in part to its free radical-promoting ability. Clinical and research experiences have suggested that the risk of bleomycin-induced pulmonary injury is increased with the administration of oxygen.
How common is bleomycin toxicity?
Bleomycin-induced pulmonary toxicity occurs in 3–5% of treated patients and is the major factor that limits its dosage.
Can bleomycin cause lung nodules?
Diffuse interstitial intra-alveolar desquamation of cells and epithelial hyperplasia are other features seen in ‘bleomycin lung’. The subpleural nodules on histologic examination simulate metastatic nodules [14].
How is bleomycin toxicity treated?
Although there is no approved standard treatment for Bleomycin induced pulmonary toxicity, some of the most common approaches until date include witholding bleomycin from subsequent chemotherapy, continuing with a non-bleomycin based regimen in relevant patients or corticosteroid treatment.
What is the most feared complication of bleomycin administration?
Phlebitis (inflammation of veins) Lung problems: pneumonitis, rarely pulmonary fibrosis.
Is pulmonary toxicity fatal?
Which adverse effects may occur in a patient using bleomycin?
More common
- Darkening or thickening of skin.
- dark stripes on skin.
- itching of skin.
- skin rash or colored bumps on fingertips, elbows, or palms.
- skin redness or tenderness.
- swelling of fingers.
- vomiting and loss of appetite.
How is drug induced pulmonary toxicity treated?
Treatment of BCNU-induced pulmonary toxicity is with corticosteroids. Patients presenting early with acute pulmonary toxicity due to BCNU are more responsive to corticosteroid therapy and have a better prognosis.