Perioperative Considerations for Patients Treated with Bleomycin (9)

In: Bleomycin

11 Apr 2013

Perioperative Considerations for Patients Treated with Bleomycin (9)These authors attributed this higher incidence of pulmonary problems in patients undergoing the resection to surgical trauma; however, patients having only an exploratory procedure may have experienced a shorter duration of hyperoxia and smaller fluid shifts than those who underwent complete resection. buy ventolin inhalers
Toxicity may be increased when bleomycin is given in combination with other chemotherapeutic agents. In patients with non-Hodgkins lymphoma, the incidence of pulmonary toxicity increased in patients receiving combination chemotherapy, especially when cyclophosphamide was employed. Because some have suggested that the immune system may contribute to fibrogenesis, it is postulated that the enhancement of bleomycin toxicity by cyclophosphamide in animals may be due to the depletion of suppressor T-cells. Whether a similar mechanism exists in humans is unknown. Because renal excretion is the primary route for elimination of bleomycin, renal failure secondary to cisplatin therapy may potentiate pulmonary toxicity. Case reports exist which describe fatal pulmonary toxicity after relatively low doses of bleomycin in the presence of cisplatin-induced renal insufficiency.
The incidence of bleomycin-induced pulmonary damage is increased in the elderly, especially in those over the age of 70 years.


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