An antibiotic drug produced by Streptomyces verticillus.
A sulfur containing anti-neoplastic agents that blocks the G2 phase of the cell cycle through inhibition of thymidine integration into replicating DNA, degradation of single and double-stranded DNA, and cleavage of cellular RNA.
Antitumor activity relates to breaking DNA double helix by producing free radicals, which are dependent on iron and oxygen.
Distributed widely throughout the body and is inactivated in every organ except his skin and lungs owing to the absence of the hydrolase enzyme responsible for the drug’s metabolism
Eliminated primarily via the kidney.
Deactivated by the enzyme bleomycin hydrolase, which is missing form the skin and lung accounting for the toxicity of those organs.
Toxicity occurs predominantly in lungs and skin.
Induced pneumonitis occurs in 0 to 46% of patients treated with bleomycin-containing chemotherapy depending upon criteria used for diagnosis.
Mortality 3% in patients with bleomycin induced pneumonitis.
General recommendation is to keep total dose <400 mg.
270 mg is considered the total dose in combination chemotherapy for disseminated good-prognosis germ-cell tumors.
Guidelines recommend baseline pulmonary function testing with measurement of the diffusing capacity of the lungs for carbon monoxide (DLCO).
In general, a DLCO threshold of at least 60% is acceptable for bleomycin use.
Symptomatic and fatal pulmonary toxic effects can be essentially eliminated by monitoring the diffusion capacity of the lung for common monoxide before each dose of Leo Mason and by stabbing therapy if the DLCO decreases.
The routine use of of granulocyte-colony-stimulating factor is not recommended.