Bleomycin for Injection should be considered a palliative treatment.It has been shown to be useful in the management of the following neoplasms either as a single agent or in proven combinations with other approved chemotherapeutic agents:
Patients receiving bleomycin must be observed carefully and frequently during and after therapy.
It should be used with extreme caution in patients with significant impairment of renal function or compromised pulmonary function.Pulmonary toxicities occur in 10% of treated patients.
In approximately 1%, the nonspecific pneumonitis induced by bleomycin progresses to pulmonary fibrosis, and death.
Although this is age and dose related, the toxicity is unpredictable.
Frequent roentgenograms are recommended (see ADVERSE REACTIONS: Pulmonary).A severe idiosyncratic reaction (similar to anaphylaxis) consisting of hypotension, mental confusion, fever, chills, and wheezing has been reported in approximately 1% of lymphoma patients treated with bleomycin.
Since these reactions usually occur after the first or second dose, careful monitoring is essential after these doses (see ADVERSE REACTIONS: Idiosyncratic Reactions).Renal or hepatic toxicity, beginning as a deterioration in renal or liver function tests, have been reported, infrequently.These toxicities may occur, however, at any time after initiation of therapy.