Delayed onset bleomycin-induced pneumonitis

Uzel, Işıl; Özgüroǧlu, Mustafa; Uzel, Burak; Kaynak, Kamil; Demirhan, Özkan; Akman, Canan; Öz, Fahrettin; Yaman, Metin

doi:10.1016/j.urology.2005.01.038

Cited by 36 publications

(29 citation statements)

References 8 publications

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“…However, bleomycin induces pulmonary fibrosis in a dose-dependent manner, and fibrosis is a major dose-limiting side effect in patients receiving bleomycin (5). Other deleterious pulmonary side effects of bleomycin also limit its clinical utility, with observations of bleomycininduced pneumonitis occurring as late as 2 years after cessation of bleomycin treatment (6).…”

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confidence: 99%

Male Sex Hormones Exacerbate Lung Function Impairment after Bleomycin-Induced Pulmonary Fibrosis

Voltz¹,

Card²,

Carey³

et al. 2008

Am J Respir Cell Mol Biol

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The roles of sex hormones as modulators of lung function and disease have received significant attention as differential sex responses to various lung insults have been recently reported. The present study used a bleomycin-induced pulmonary fibrosis model in C57BL/6 mice to examine potential sex differences in physiological and pathological outcomes. Endpoints measured included invasive lung function assessment, immunological response, lung collagen deposition, and a quantitative histological analysis of pulmonary fibrosis. Male mice had significantly higher basal static lung compliance than female mice (P , 0.05) and a more pronounced decline in static compliance after bleomycin administration when expressed as overall change or percentage of baseline change (P , 0.05). In contrast, there were no significant differences between the sexes in immune cell infiltration into the lung or in total lung collagen content after bleomycin. Total lung histopathology scores measured using the Ashcroft method did not differ between the sexes, while a quantitative histopathology scoring system designed to determine where within the lung the fibrosis occurred indicated a tendency toward more fibrosis immediately adjacent to airways in bleomycin-treated male versus female mice. Furthermore, castrated male mice exhibited a female-like response to bleomycin while female mice given exogenous androgen exhibited a male-like response. These data indicate that androgens play an exacerbating role in decreased lung function after bleomycin administration, and traditional measures of fibrosis may miss critical differences in lung function between the sexes. Sex differences should be carefully considered when designing and interpreting experimental models of pulmonary fibrosis in mice.

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confidence: 99%

Male Sex Hormones Exacerbate Lung Function Impairment after Bleomycin-Induced Pulmonary Fibrosis

Voltz¹,

Card²,

Carey³

et al. 2008

Am J Respir Cell Mol Biol

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“…Symptoms associated with bleomycin lung injury are often nonspecific and often develop a few months following therapy. 13 These patients commonly present with dry cough, chest pain, dyspnea, fever, tachypnea, bilateral auscultatory crackles, and hypoxemia. However, the onset of symptoms tends to be more acute and rapidly progressive.…”

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confidence: 99%

Beyond Conventional Therapy: Role of Pulse Steroids in Bleomycin Induced Lung Injury

Gupta¹,

Ettinger

2013

Respir Care

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“…White et al (1984) reported one patient developed BLM-induced pneumonitis six month after discontinuation of the chemotherapy. In another case, patient with nonseminomatous testicular cancer developed pneumonitis two years after completion of BLM treatment (Uzel et al 2005). In our patient, tachypnea had been observed during chemotherapy with BLM, and therefore BLMinduced pneumonitis might have been present around the same time, in spite of there being no chest radiographic findings one year after completion of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…The mortality of patients with BLM-induced pneumonitis is 3% (Levi et al 1993). The clinical manifestations of BLM lung toxicity usually occur during treatment, but pneumonitis can develop up to two years after completion of BLM therapy (Uzel et al 2005).…”

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Lung Fibrosis 10 Years after Cessation of Bleomycin Therapy

Tashiro

Izumikawa

Yoshioka

et al. 2008

Tohoku J. Exp. Med.

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Bleomycin (BLM) is a chemotherapeutic agent used for the treatment of several types of malignancy, including germ cell tumors, lymphoma, and certain types of squamous-cell carcinoma. The common adverse effect of BLM is interstitial pneumonitis, followed by pulmonary fibrosis. BLM-induced pneumonitis occurs in up to 46% of patients treated with BLM-containing chemotherapy and lung toxicity usually appears during treatment. Here we describe a patient with lung fibrosis, who presented with slow progressive breathlessness and pneumothorax more than 10 years after cessation of BLM therapy. A 15 yearold girl presented with abnormal shadows on chest X-ray. The patient had a yolk sac carcinoma in the sacral region at 1 year of age and obtained complete remission after being treated with tumor resection, radiation, and several anti-cancer drugs including BLM. There were no abnormal findings in chest X-ray until she reached 3 years of age, when she had developed respiratory distress that worsened with age. The patient had experienced an episode of pneumothorax at 13 years of age. Chest CT at the time revealed interstitial reticular opacities. Radiological findings and pathological examination of the lung tissue obtained during bullectomy with video-assisted thoracic surgery were compatible with BLM-induced pneumonitis. The present study suggests that lung fibrosis may surface more than 10 years after cessation of BLM therapy at the age of 1 year, with no chest radiographic findings 1 year after completion of chemotherapy. The use of BLM in infants requires strict supervision and observation and careful long-term follow up. Bleomycin; child; pneumonitis; pneumothorax Tohoku J. Exp. Med., 2008, 216 (1), 77-80. © 2008 Tohoku University Medical Press Bleomycin (BLM) is a chemotherapeutic agent used for the treatment of several types of malignancy, including germ cell tumors, lymphoma, and certain squamous-cell carcinoma. Most significant adverse effect of BLM is interstitial pneumonitis, followed by pulmonary fibrosis.

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Delayed onset bleomycin-induced pneumonitis

Cited by 36 publications

References 8 publications

Male Sex Hormones Exacerbate Lung Function Impairment after Bleomycin-Induced Pulmonary Fibrosis

Male Sex Hormones Exacerbate Lung Function Impairment after Bleomycin-Induced Pulmonary Fibrosis

Beyond Conventional Therapy: Role of Pulse Steroids in Bleomycin Induced Lung Injury

Lung Fibrosis 10 Years after Cessation of Bleomycin Therapy

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