Incidence, outcome and predictors of bleomycin pulmonary toxicity in a university hospital in Oman

• Published in: Journal of oncology pharmacy practice 2013-03, Vol.19 (1), p.3-7
• Main Authors: Ahmed, Bushra M, Al-Zakwani, Ibrahim S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Antibiotics; Antibiotics, Antineoplastic - administration & dosage; Antibiotics, Antineoplastic - adverse effects; Antibiotics, Antineoplastic - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bleomycin - adverse effects; Bleomycin - therapeutic use; Cohort Studies; Drug Monitoring; Female; Hodgkin Disease - drug therapy; Hodgkin Disease - mortality; Hospitals, University; Humans; Incidence; Lung - drug effects; Lung Diseases - chemically induced; Lung Diseases - epidemiology; Lung Diseases - mortality; Lungs; Male; Middle Aged; Oman - epidemiology; Retrospective Studies; Risk Factors; Toxicity; Young Adult
• ISSN: 1078-1552; 1477-092X
• DOI: 10.1177/1078155212444649

Objectives: To determine the incidence and predictors of bleomycin pulmonary toxicity in a university hospital in Oman. Methods: This retrospective chart review consisted of 46 patients treated with bleomycin-containing regimes at Sultan Qaboos University Hospital in Oman between January 2007 and December 2010. Data regarding patient age, chemotherapy protocol, cumulative bleomycin dose, smoking history, renal function and concurrent use of granulocyte colony stimulating factor (GCSF) were collected from the hospital’s electronic database. Analyses were performed using univariate statistical techniques. Results: Of the 46 patients, 22% (n = 10) experienced bleomycin pulmonary toxicity. There was an overall mortality of 4.3% (n = 2; N = 46), with significantly more deaths in the bleomycin pulmonary toxicity group compared to the cohort that did not have bleomycin pulmonary toxicity (20% versus 0%; p = 0.043). The bleomycin pulmonary toxicity group was significantly older compared to the cohort that did not have bleomycin pulmonary toxicity (48 versus 34 years; p = 0.017). Furthermore, adriamycin, bleomycin, vinblastine, dacarbazine, as front-line chemotherapy, was found to have a trend towards increased risk of bleomycin pulmonary toxicity (90% versus 56%; p = 0.067; power = 31%). There did not seem to be significant differences in bleomycin dose (143 versus 149 units; p = 0.727), smoking status (10% versus 14%; p = 1.000) and systolic blood pressure (133 versus 131 mmHg; p = 0.746) between the two study groups. Conclusion: This study confirms a relatively high incidence of bleomycin pulmonary toxicity in a tertiary hospital in Oman. Older patients were significantly more likely to suffer bleomycin pulmonary toxicity compared to younger patients.