Life-threatening bleomycin pulmonary toxicity with ultimate reversibility.
A 60-year-old man with advanced seminoma was treated with four cycles of a cisplatin, etoposide and bleomycin. He then developed severe pulmonary toxicity with diffuse infiltrates as evidenced on a chest x-ray film. The room air PaO2 value was 32 mm Hg. The patient was treated with steroids and oxygen supplementation, including a high FIo2 for several days, and survived and eventually experienced marked improvement in his pulmonary status. Aggressive management of severe bleomycin-induced pneumonitis appears justified.
Department of Medical Oncology, Mayo Clinic, Rochester, MN.
L C
LC
Hartmann
S
S
Frytak
R L
RL
Richardson
D T
DT
Coles
R E
RE
Cupps
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage; D004407:Dysgerminoma / Q000188:drug therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011014:Pneumonia / Q000139:chemically induced* / Q000628:therapy; D011241:Prednisone / Q000627:therapeutic use
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin; D011241:Prednisone; D008775:Methylprednisolone