Evaluation of Respiratory Functions in Pediatric Oncology Patients
Receiving Bleomycin Treatment
Abstract
Purpose: Bleomycin is a chemotherapeutic agent that causes lung
toxicity. Bleomycin is mostly used in the treatment of germ cell
tumors(GCT) and Hodgkin Lymphoma(HL) in childhood cancers. In this
study, we aimed to detect bleomycin toxicity to the lung in the early
period. Materials and methods: Pulmonary functions of patients
aged 5 years and older who were admitted to the Division of Pediatric
Oncology with germ cell tumors and Hodgkin Lymphoma between 2012 and
2022, who received bleomycin treatment and were in remission for at
least 6 months were evaluated. The evaluation of respiratory function
was based on history, physical examination, posteroanterior chest
radiography and pulmonary function test. Results: There were
109 patients with GCT and 122 patients with HL. The number of patients
with GCT who entered follow-up and lived were 59, those with HL were
89]. The number of patients who received bleomycin treatment, were in
remission for at least 6 months and underwent PFTs were 46 for HL and 12
for GCT. There were 21 patients with PFT abnormalities. Of these
patients, 3 were diagnosed with GCT and 18 were diagnosed with HL. The
type of PFT abnormality in the majority of patients was restrictive
disorder. Conclusion: The absence of respiratory symptoms in
90% of patients with PFT abnormalities shows the importance of PFT in
asymptomatic patients. Patients who have received bleomycin as part of
treatment should also be followed-up for late pulmonary toxicity.