title: Death by bleomycin pulmonary toxicity in ovarian dysgerminoma with pathologic complete response to chemotherapy. A case report.
abstract: With cisplatin-based chemotherapy, most patients with ovarian dysgerminoma will survive long-term. Bleomycin is an important part of ovarian germ cell tumors (OGCT) treatment, and its dose-limiting toxicity is the development of pulmonary toxicity and it is increased in patients older than 40 years. We report the case of an elderly patient with an unresectable ovarian dysgerminoma who received neoadjuvant chemotherapy and who developed fatal bleomycin pulmonary toxicity (BPT) after surgery. A monitoring of pulmonary function is not routinely recommended for detecting BPT, although together with carefully assessment for symptoms or signs suggestive of pulmonary toxicity is the best way to reduce the risk of BPT. The frequency of pulmonary events in older patients makes us to think about the possibility of either reduce the dose of bleomycin or removing it from the BEP in ovarian GCT.
authors.affiliation: Department of Medical Oncology, University Hospital Fuenlabrada, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Calzas Rodríguez
authors.affiliation: Department of Pulmonology, University Hospital Fuenlabrada, Spain.
authors.forename: María Del
authors.initials: MD
authors.lastname: Carmen Juarez Morales
authors.affiliation: Department of Pulmonology, University Hospital Fuenlabrada, Spain.
authors.forename: Miguel Angel Racionero
authors.initials: MA
authors.lastname: Casero
keywords: BEP, Bleomycin, Etoposide, Cisplatin; BPT, bleomycin pulmonary toxicity; Bleomycin; CT, computed tomography; OGCT, Ovarian germ cell tumors; Older patients; Ovarian dysgerminoma; Pulmonary function test; Pulmonary toxicity