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

I.v

Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence

Significant reduction in lung volumes and/or diffusing capacity for CO (>40%) from baseline may annunciate overt bleomycin pulmonary toxicity. Risk of continuation vs. benefit of therapy with, and risk of withdrawal of the drug has to be discussed on a case-by-case baisis. Lower than normal results of PFT are also described as a late effet of treatments with bleomycin (PMID 26422284)

Publications

De A, Guryev I, LaRiviere A, Kato R, Wee CP, Mascarenhas L, Keens TG, Venkatramani R

Pulmonary function abnormalities in childhood cancer survivors treated with bleomycin.

Pediatric blood & cancer. 2014;61(9):1679-84

Sleijfer S

Pulmonary alterations during BEP? Always be aware of BIP.

Onkologie. 2007;30(6):291-2

Sleijfer S, van der Mark TW, Schraffordt Koops H, Mulder NH

Decrease in pulmonary function during bleomycin-containing combination chemotherapy for testicular cancer: not only a bleomycin effect.

British journal of cancer. 1995;71(1):120-3

Lewis BM, Izbicki R

Routine pulmonary function tests during bleomycin therapy. Tests may be ineffective and potentially misleading.

JAMA. 1980;243(4):347-51

Wolkowicz J, Sturgeon J, Rawji M, Chan CK

Bleomycin-induced pulmonary function abnormalities.

Chest. 1992;101(1):97-101

Villani F, Bacchella L, Bulgheroni A, Pizzini L, Galimberti M, Aprile C, Luisetti M

Study of functional and biochemical indicators of subclinical lung damage in bleomycin-treated patients.

Respiratory medicine. 1992;86(4):327-33

Comis RL, Kuppinger MS, Ginsberg SJ, Crooke ST, Gilbert R, Auchincloss JH, Prestayko AW

Role of single-breath carbon monoxide-diffusing capacity in monitoring the pulmonary effects of bleomycin in germ cell tumor patients.

Cancer research. 1979;39(12):5076-80