Perioperative Considerations for Patients Treated with Bleomycin (10)

In: Bleomycin

12 Apr 2013

One of the possible causes of this increased toxicity may be a decrease in the labile bleomycin-inactivating enzyme; however, variables such as diet, underlying pulmonary disease, diminution of pulmonary and renal function with aging, or previous exposure to environmental toxins or other drugs may also play a role.
Smoking
Several investigators have compared the incidence of toxicity in bleomycin-treated smokers and nonsmokers. Parvinen et al found that the frequency of pulmonary fibrosis after bleomycin was not enhanced by a history of cigarette smoking. Another study compared pulmonary function tests and Dsb before, during, and after bleomycin therapy in smokers and nonsmokers. This study showed no difference in spirometric measurements between the two groups; however, there was a significant change in the Dsb of smokers compared to nonsmokers. Both groups experienced an initial increase in Dsb during the first two months of treatment. Thereafter, the Dsb of the smokers significantly decreased to a median minimum of 72 percent of predicted, while that of the nonsmokers showed an insignificant decrease. This reduction in Dsb was not progressive, but recovery did not occur over time.


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