In: Bleomycin9 Apr 2013
It is difficult to draw any conclusions because the number of patients in these studies is small, and pulmonary metastases may also cause abnormalities on spirometry. Lewis and Izbicld concluded that the results of routine pulmonary function testing in patients treated with bleomycin may be misleading, because false-positive and false-negative results were common in their study.
The Dsb test has been studied as a possible predictor of the extent of pulmonary damage after bleomycin therapy. Several reviews concluded that sequential studies of Dsb may be more predictive than spirometry; however, Piotti et al found no relationship between Dsb and the severity of histologic changes in their series of 16 patients. Lewis and Izbicki cautioned that the anemia often seen in cancer patients receiving chemotherapy can cause a falsely low Dsb value. Selvin, in her review article on anesthesia in the patient receiving chemotherapy, suggested that history and physical examination were more important indicators of the extent of disease than pulmonary function tests. flovent inhaler
Potentiators of Toxicity
Several factors have been either proven or postulated to increase the risk of pulmonary toxicity with bleomycin. Some investigators have found that the intravenous route of administration was more likely to cause pulmonary damage than the intramuscular route, while others have found no difference in the incidence of toxicity based on the route of administration.
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