Factors influencing postoperative morbidity and mortality in patients treated with bleomycin.

Goldiner, Paul L.; Carlon, Graziano C.; Cvitkovic, Esteban; Schweizer, O; Howland, William S.

doi:10.1136/bmj.1.6128.1664

Cited by 201 publications

(54 citation statements)

References 9 publications

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“…Cyclophosphamide, vincristine, doxorubicin, and methotrexate with bleomycin have also been reported to increase the risk of fi brosis. 7 Goldiner et al 78 reported that the use of oxygen therapy (mean concentration, 39%) during and after pulmonary resection in fi ve patients with testicular cancer who were treated with bleomycin (400 Ϯ 180 mg) 6 to 12 months prior, resulted in 100% mortality because of respiratory distress. Postmortem examination showed severe alveolar wall damage consistent with bleomycin-induced pulmonary injury.…”

Section: Pulmonary Function and Loss Of Optimal Exercise Capacitymentioning

confidence: 99%

Pulmonary Outcomes in Survivors of Childhood Cancer

Huang

Hudson

Stokes

et al. 2011

Chest

136

137

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O ver the last 3 decades, therapeutic progress has resulted in a growing population of survivors of childhood cancer. In 2006, there were Ͼ 11 million cancer survivors in the United States, three times the number of survivors in 1971. 1 The 5-year survival rate for children diagnosed with cancer is approaching 85%, 2 and an estimated one in 570 individuals in the United States between the ages of 20 and 34 is a survivor of childhood cancer. 3 Unfortunately, increased survival rates are not without consequences. There is substantial evidence Background: The purpose of this article is to summarize the literature that documents the longterm impact of cancer treatment modalities on pulmonary function among survivors of cancer and to identify potential areas for further research. Methods: Systematic reviews of clinical trials, observational studies, case series, and review articles were conducted. Articles were limited to the studies that discussed pulmonary toxicity or late effects among pediatric cancer survivors and to follow-up investigations that were conducted a minimum of 2 years after completion of cancer-related treatment or 1 year after hematopoietic stem cell transplant. Results: Sixty publications (51 clinical studies/reports and nine reviews) published from January 1970 to June 2010 in PubMed met the inclusion criteria. Data showed an association between radiotherapy, alkylating agents, bleomycin, hematopoietic stem cell transplant, and thoracic surgery and pulmonary toxicity, as well as possible interactions among these modalities. Conclusions: Pulmonary toxicity is a common long-term complication of exposure to certain anticancer therapies in childhood and can vary from subclinical to life threatening. Pulmonary function and associated loss of optimal exercise capacity may have adverse effects on long-term quality of life in survivors. Lung function diminishes as a function of normal aging, and the effects of early lung injury from cancer therapy may compound these changes. The information presented in this review is designed to provide a stimulus to promote both observational and interventional research that expands our knowledge and aids in the design of interventions to prevent or ameliorate pulmonary late effects among survivors of childhood cancer. CHEST 2011; 140(4):881-901Abbreviations: ALL 5 acute lymphoblastic leukemia; BCNU 5 carmustine; CCNU 5 lomustine; D lco 5 diffusing capacity of the lung for carbon monoxide; GVHD 5 graft-vs-host disease; gy 5 gray; HL 5 Hodgkin's lymphoma; HSCT 5 hematopoietic stem cell transplant; NHL 5 non-Hodgkin's lymphoma; PFT 5 pulmonary function testing; TLC 5 total lung capacity

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Section: Pulmonary Function and Loss Of Optimal Exercise Capacitymentioning

confidence: 99%

Pulmonary Outcomes in Survivors of Childhood Cancer

Huang

Hudson

Stokes

et al. 2011

Chest

136

137

View full text Add to dashboard Cite

show abstract

“…10 Bleomycin can cause dose-dependent alveolitis with nodular infiltrates and fibrosis in 3-4% of treated subjects; this risk is higher in patients who need oxygen therapy. 11,12 Melphalan and azathioprine have been described to elicit (rarely) interstitial alveolitis and chronic bronchitis, respectively, 13,14 and interleukin-2 can cause non-cardiogenic pulmonary edema. 15 Restrictive and obstructive respiratory impairment have been reported in children after bone marrow transplant; they appear to be associated with heavy pre-transplantation drug therapy.…”

Section: Discussionmentioning

confidence: 99%

Non-infectious interstitial alveolitis and foreign body pulmonary vasculitis in a child treated for acute lymphoblastic leukemia

et al. 1997

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“…However, this issue is debatable. 2,3 Nevertheless, it may be clinically relevant as many of the patients who receive bleomycin therapy for a variety of disorders are relatively young and may subsequently undergo surgery where general anaesthesia would be considered. Awareness and knowledge of these risk factors would certainly prove invaluable in preventing/ avoiding perioperative complications in a patient with prior exposure to bleomycin.…”

Section: Replymentioning

confidence: 99%

“…Even a modest increase in fraction of inspired oxygen (FiO 2 ) to 0.32 or 0.45, intra-operatively, has reportedly resulted in lung toxicity and death. 2 Further, the duration of this relationship is not well characterised. An exposure to Bleomycin in the past six months is considered by some to be a significant risk factor; 2 however for delivery of HBOT, even a remote history of Bleomycin therapy is an absolute contraindication.…”

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confidence: 99%