The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

II.b

ARDS - Acute lung injury

Bleomycin-induced ARDS can be hyperacute and fatal in a few days. Although oxygen may potentiate bleomycin toxicity, exposure to oxygen later in life after temination of treatment may have no detrimental consequences (PMID 23045915).

Publications

Gerard L, Bidoul T, Castanares-Zapatero D, Wittebole X, Lacroix V, Froidure A, Hoton D, Laterre PF

Open Lung Biopsy in Nonresolving Acute Respiratory Distress Syndrome Commonly Identifies Corticosteroid-Sensitive Pathologies, Associated With Better Outcome.

Critical care medicine. 2018;46(6):907-914

Madabhavi I, Modi G, Patel A, Anand A, Panchal H, Parikh S

Pulmonary toxicity following bleomycin use: A single-center experience.

Journal of cancer research and therapeutics. 2017;13(3):466-470

Gibelin A, Parrot A, Maitre B, Brun-Buisson C, Mekontso Dessap A, Fartoukh M, de Prost N

Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition.

Intensive care medicine. 2016;42(2):164-72

Godoy MC, Nonaka D, Raphael BG, Vlahos I

Diffuse ground-glass opacities in a patient with Hodgkin lymphoma and progressive respiratory failure.

Chest. 2008;134(1):207-12

Sleijfer S

Bleomycin-induced pneumonitis.

Chest. 2001;120(2):617-24

Simpson AB, Paul J, Graham J, Kaye SB

Fatal bleomycin pulmonary toxicity in the west of Scotland 1991-95: a review of patients with germ cell tumours.

British journal of cancer. 1998;78(8):1061-6

Blayney DW, Goldberg DA, Leong LA, Margolin KA, Burke JS, Doroshow JH

High-risk germ cell tumors in men. High response rate and severe toxicity with cisplatin, vinblastine, bleomycin, and etoposide.

Cancer. 1993;71(7):2351-7

White DA, Stover DE

Severe bleomycin-induced pneumonitis. Clinical features and response to corticosteroids.

Chest. 1984;86(5):723-8

Balikian JP, Jochelson MS, Bauer KA, Skarkin AT, Garnick MB, Canellos GP, Smith EH

Pulmonary complications of chemotherapy regimens containing bleomycin.

AJR. American journal of roentgenology. 1982;139(3):455-61

Ganick DJ, Peters ME, Hafez GR

Acute bleomycin toxicity.

The American journal of pediatric hematology/oncology. 1980;2(3):249-52

Perez-Guerra F, Harkleroad LE, Walsh RE, Costanzi JJ

Acute bleomycin lung.

The American review of respiratory disease. 1972;106(6):909-13

Gilson AJ, Sahn SA

Reactivation of bleomycin lung toxicity following oxygen administration. A second response to corticosteroids.

Chest. 1985;88(2):304-6

Crooke ST, Einhorn LH, Comis RL, D'Aoust JC, Prestayko AW

The effects of prior exposure to bleomycin on the incidence of pulmonary toxicities in a group of patients with disseminated testicular carcinomas.

Medical and pediatric oncology. 1978;5(1):93-8

Iacovino JR, Leitner J, Abbas AK, Lokich JJ, Snider GL

Fatal pulmonary reaction from low doses of bleomycin. An idiosyncratic tissue response.

JAMA. 1976;235(12):1253-5