Prognostic impact of bleomycin pulmonary toxicity on the outcomes of patients with germ cell tumors

Prognostic impact of bleomycin pulmonary toxicity on the outcomes of patients with germ cell tumors Bleomycin pulmonary toxicity (BPT) has been well described in patients with germ cell tumors treated with bleomycin etoposide and cisplatin chemotherapy (BEP). To assess the prognostic impact of BPT, we retrospectively identified 52 patients who underwent bleomycin etoposide and cisplatin chemotherapy from 2008 to 2017 in our institution, and evaluated the risk factors of BPT and its effect on prognosis. Patients who had received chemotherapy at another institution were excluded. BPT was defined as bleomycin discontinuation in response to pulmonary function test decline, pulmonary symptoms, or interstitial pneumonia on computed tomography without infection. We divided the patients into two groups according to this definition: BPT and non-BPT. Their median age was 34.2 years, and their median body mass index was 22.8 kg/m2. Twenty patients had a smoking history, 37 were diagnosed with non-seminoma, and 20 had lung metastasis. The median cumulative bleomycin dose was 270 mg/body. Fifteen patients were classified into the BPT group and 37 into the non-BPT group. Only body mass index < 22 was identified as a predictor of BPT in multivariable logistic models. Age or use of granulocyte-colony stimulating factor did not have a significant impact. Kaplan–Meier analysis revealed that the presence of BPT had no significant impact on either 5-year overall survival or progression-free survival. Lower body mass index can increase the risk of BPT in patients with germ cell tumors undergoing BEP. However, discontinuation of bleomycin with BPT does not adversely influence the survival outcomes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medical Oncology Springer Journals

Prognostic impact of bleomycin pulmonary toxicity on the outcomes of patients with germ cell tumors

Download PDF
8 pages
Read Article

Loading next page...
 
/lp/springer-journals/prognostic-impact-of-bleomycin-pulmonary-toxicity-on-the-outcomes-of-E0xuFowcxU
Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Oncology; Hematology; Pathology; Internal Medicine
ISSN
1357-0560
eISSN
1559-131X
DOI
10.1007/s12032-018-1140-5
pmid
29700638
Publisher site
See Article on Publisher Site

Abstract

Bleomycin pulmonary toxicity (BPT) has been well described in patients with germ cell tumors treated with bleomycin etoposide and cisplatin chemotherapy (BEP). To assess the prognostic impact of BPT, we retrospectively identified 52 patients who underwent bleomycin etoposide and cisplatin chemotherapy from 2008 to 2017 in our institution, and evaluated the risk factors of BPT and its effect on prognosis. Patients who had received chemotherapy at another institution were excluded. BPT was defined as bleomycin discontinuation in response to pulmonary function test decline, pulmonary symptoms, or interstitial pneumonia on computed tomography without infection. We divided the patients into two groups according to this definition: BPT and non-BPT. Their median age was 34.2 years, and their median body mass index was 22.8 kg/m2. Twenty patients had a smoking history, 37 were diagnosed with non-seminoma, and 20 had lung metastasis. The median cumulative bleomycin dose was 270 mg/body. Fifteen patients were classified into the BPT group and 37 into the non-BPT group. Only body mass index < 22 was identified as a predictor of BPT in multivariable logistic models. Age or use of granulocyte-colony stimulating factor did not have a significant impact. Kaplan–Meier analysis revealed that the presence of BPT had no significant impact on either 5-year overall survival or progression-free survival. Lower body mass index can increase the risk of BPT in patients with germ cell tumors undergoing BEP. However, discontinuation of bleomycin with BPT does not adversely influence the survival outcomes.

Journal

Medical Oncology – Springer Journals

Published: Apr 26, 2018

References

  • Importance of bleomycin in favorable-prognosis disseminated germ cell tumors: an Eastern Cooperative Oncology Group trial
    Loehrer, P; Johnson, D; Elson, P; Einhorn, LH; Trump, D
  • Importance of bleomycin in combination chemotherapy for good-prognosis testicular nonseminoma: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group
    Wit, R; Stoter, G; Kaye, SB
  • International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancer. International Germ Cell Cancer Collaborative Group
  • A clinical review of bleomycin - a new antineoplastic agent
    Blum, RH; Carter, SK; Aqre, K
  • Predicting the risk of bleomycin lung toxicity in patients with germ-cell tumours
    O’Sullivan, JM; Huddart, RA; Norman, AR; Nicholls, J; Dearnaley, DP; Horwich, A
  • The importance of bleomycin in combination chemotherapy for good-prognosis germ cell carcinoma. Australasian Germ Cell Trial Group
    Levi, JA; Raghavan, D; Thompson, D
  • Predictive factors for bleomycin-induced pneumonitis
    Barneveld, P; Mark, DT; Sleijfer, T
  • Fatal bleomycin pulmonary toxicity in the west of Scotland 1991-95: a review of patients with germ cell tumours
    Simpson, A; Paul, J; Graham, J; Kaye, S
  • Bleomycin pulmonary toxicity does not adversely affect the outcome of patients with Hodgkin lymphoma
    Sun, HL; Atenafu, EG; Tsang, R
  • Bleomycin pulmonary toxicity has a negative impact on the outcome of patients with Hodgkin’s lymphoma
    Martin, WG; Ristow, KM; Habermann, TM; Colqan, JP; Witziq, TE; Ansell, SM
  • Impact of granulocyte-colony stimulating factor on bleomycin-induced pneumonitis in chemotherapy-treated germ cell tumors
    Kwan, EM; Beck, S; Amir, E
  • Comparison of two standard chemotherapy regimens for good-prognosis germ cell tumors: updated analysis of a randomized trial
    Grimison, PS; Stockler, MR; Thomson, DB
  • Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics
    Kanda, Y
  • Pulmonary toxicity in patients with advanced-stage germ cell tumors receiving bleomycin with oud without granulocyte colony stimulating factor
    Saxman, SB; Nichols, CR; Einhorn, LH
  • The effect of pulmonary function testing on bleomycin dosing in germ cell tumours
    Roncolate, FT; Chatfield, M; Hougton, B
  • Carbon monoxide diffusing capacity is a poor predictor of clinically significant bleomycin lung. New Zealand Clinical Oncology Group
    McKeage, MJ; Evans, BD; Atkinson, C; Perez, D; Forgeson, GV; Dady, P
  • Role of carbon monoxide diffusing capacity in the early detection of major bleomycin-induced pulmonary toxicity
    Bell, MR; Meredith, DJ; Gill, OG
  • Detecting bleomycin pulmonary toxicity: a continued conundrum
    Comis, RL
  • A randomized phase III study of 72 h infusional versus bolus bleomycin in BEP (bleomycin, etoposide and cisplatin) chemotherapy to treat IGCCCG good prognosis metastatic germ cell tumours (TE-3)
    Shamash, J; Sarker, SJ; Huddart, R
  • Bleomycin pulmonary toxicity: its relationship to renal dysfunction
    Dalgleish, AG; Woods, RL; Levi, JA
  • Bleomycin pulmonary toxicity has a negative impact on the outcome of patients with Hodgkin’s lymphoma
    Martin, W; Ristow, K; Habermann, T
  • Low BMI is correlated with increased TGF-β and IL-10 mRNA levels in the peripheral blood of breast cancer patients
    Lic, C; Wang, Q; Sun, B
  • Transforming growth factor beta in tissue fibrosis
    Border, WA; Noble, NA
  • Deranged fatty acid composition causes pulmonary fibrosis in Elovl6-deficient mice
    Sunaga, H; Matsui, H; Ueno, M
  • Predictors of accelerated decline in lung function in adult-onset asthma
    Coumou, H; Westerhof, GA; Nijs, SB; Zwinderman, AH; Bel, EH
  • Cisplatin, etoposide, bleomycin first-line therapy and early resection of residual tumor in far-advanced germinal testis cancer
    Pizzocaro, G; Piva, L; Salvioni, R; Zanoni, F; Milani, A
  • Effect of bleomycin administration on the development of pulmonary toxicity in patients with metastatic germ cell tumors receiving first-line chemotherapy: a meta-analysis of randomized studies
    Necchi, A; Miceli, R; Oualla, K
  • BEP versus EP for treatment of metastatic germ-cell tumours
    Jankilevich, G
  • Part II: testicular cancer—management of advanced disease
    Jones, RH; Vasey, PA
  • Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: a randomized trial of the Genito-Urinary Group of the French Federation of Cancer Centers (GETUG T93BP)
    Culine, S; Kerbrat, P; Kramar, A

You’re reading a free preview. Subscribe to read the entire article.

Try 2 weeks free now

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

or browse the journals available

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off

Sign up
for free
Start 14 day
Free Trial