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6. [Consortium for detection and management of lung damage induced by bleomycin].

Author

Biya J, Stoclin A, Dury S, Le Pavec J, Mir O, Lazarovici J, Fermé C, Annereau M, Ekpe K, Massard C, and Michot JM

Subjects
Adrenal Cortex Hormones therapeutic use, Endothelium, Vascular drug effects, Humans, Lung Diseases, Interstitial chemically induced, Lung Diseases, Interstitial diagnosis, Lung Diseases, Interstitial drug therapy, Lung Diseases, Interstitial physiopathology, Pneumonia diagnosis, Pneumonia drug therapy, Pneumonia physiopathology, Pulmonary Eosinophilia chemically induced, Pulmonary Eosinophilia diagnosis, Pulmonary Eosinophilia drug therapy, Pulmonary Eosinophilia physiopathology, Risk Factors, Withholding Treatment, Antibiotics, Antineoplastic adverse effects, Bleomycin adverse effects, Pneumonia chemically induced
Abstract

Bleomycin is a cytotoxic antibiotic and a component of chemotherapy regimens of germ cell tumors and lymphoma. Bleomycin lung injuries occur in 10% of patients, and lead to severe interstitial pneumonia in 3% of patients. Pulmonary toxicity is related to endothelial cells injury induce by free radicals and inflammatory cytokines. Diagnosis of bleomycin-induced lung toxicity is based on the combination of clinical and radiological features, and requires to rule out differential diagnoses including pneumocystis. "Bleomycin-induced pneumonitis" is the most frequent pattern; eosinophilic pneumonitis and organizing pneumonia are rarer. Occurrence of bleomycin lung toxicity requires an immediate and often permanent discontinuation. Treatment is based on steroid. Regular clinical and pulmonary function tests monitoring are mandatory for early detection of bleomycin-induced lung toxicity., (Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Published
2016
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