Pulmonary Fibrosis as a Complication of Chemotherapy Agents

Evidence for Bleomycin-Induced Pulmonary Fibrosis

Bleomycin forms a key component of curative regimens for lymphoma and germ cell tumors but can be associated with severe toxicity, long-term complications, and even death in extreme cases 1
Bleomycin-induced pneumonitis (BIP) is estimated to occur in approximately 10% of germ cell tumor patients and can be life-threatening in up to 20% of these cases 1
Immune-mediated hypersensitivity with potential genetic predisposition plays an important role in the pathogenesis and subsequent fibrosis 1

Advanced age is a risk factor for bleomycin-induced pulmonary fibrosis 1
Smoking history, renal dysfunction, and prior mediastinal radiotherapy are also risk factors for bleomycin-induced pulmonary fibrosis 2

Cyclophosphamide and methotrexate are known to induce pulmonary toxicity, but less commonly than bleomycin, according to the National Comprehensive Cancer Network 3

Careful monitoring of pulmonary function is essential during and after bleomycin therapy, as recommended by the British Journal of Cancer 1
Treatment with systemic corticosteroids early in the course of illness has been associated with clinical and radiographic improvement, as reported in the European Respiratory Review 4