title: Incidence, outcome and predictors of bleomycin pulmonary toxicity in a university hospital in Oman.
abstract: OBJECTIVE
  To determine the incidence and predictors of bleomycin pulmonary toxicity in a university hospital in Oman.
  
  
  METHODS
  This retrospective chart review consisted of 46 patients treated with bleomycin-containing regimes at Sultan Qaboos University Hospital in Oman between January 2007 and December 2010. Data regarding patient age, chemotherapy protocol, cumulative bleomycin dose, smoking history, renal function and concurrent use of granulocyte colony stimulating factor (GCSF) were collected from the hospital's electronic database. Analyses were performed using univariate statistical techniques.
  
  
  RESULTS
  Of the 46 patients, 22% (n = 10) experienced bleomycin pulmonary toxicity. There was an overall mortality of 4.3% (n = 2; N = 46), with significantly more deaths in the bleomycin pulmonary toxicity group compared to the cohort that did not have bleomycin pulmonary toxicity (20% versus 0%; p = 0.043). The bleomycin pulmonary toxicity group was significantly older compared to the cohort that did not have bleomycin pulmonary toxicity (48 versus 34 years; p = 0.017). Furthermore, adriamycin, bleomycin, vinblastine, dacarbazine, as front-line chemotherapy, was found to have a trend towards increased risk of bleomycin pulmonary toxicity (90% versus 56%; p = 0.067; power = 31%). There did not seem to be significant differences in bleomycin dose (143 versus 149 units; p = 0.727), smoking status (10% versus 14%; p = 1.000) and systolic blood pressure (133 versus 131 mmHg; p = 0.746) between the two study groups.
  
  
  CONCLUSIONS
  This study confirms a relatively high incidence of bleomycin pulmonary toxicity in a tertiary hospital in Oman. Older patients were significantly more likely to suffer bleomycin pulmonary toxicity compared to younger patients.
authors.affiliation: Department of Pharmacy, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
authors.forename: Bushra M
authors.initials: BM
authors.lastname: Ahmed
authors.forename: Ibrahim S
authors.initials: IS
authors.lastname: Al-Zakwani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D016903:Drug Monitoring; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008168:Lung / Q000187:drug effects*; D008171:Lung Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009850:Oman / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin