Possible toxicity with the association of G-CSF and bleomycin

Bastion, Y.; Reyes, F; Bosly, André; Gisselbrecht, Christian; Yver, Antoine; Gilles, E; Maral, J; Coiffier, B

doi:10.1016/s0140-6736(94)92426-0

Cited by 37 publications

(19 citation statements)

References 3 publications

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“…This is also true for this study where four patients (25%) experienced mild to moderate musculoskeletal pain. There had been reports suggesting that G-CSF may augment bleomycin induced pulmonary toxicity (20)(21) been questioned by others (22). No such toxicity was found in the present study.…”

Section: Discussioncontrasting

confidence: 63%

G-CSF (Filgrastim) as an Adjunct to MOPP/ABVD Therapy in Hodgkin's Disease

Gustavsson

1997

Acta Oncologica

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Section: Discussioncontrasting

confidence: 63%

G-CSF (Filgrastim) as an Adjunct to MOPP/ABVD Therapy in Hodgkin's Disease

Gustavsson

1997

Acta Oncologica

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“…Concern has been expressed that coincident use of bleomycin and neutrophil growth factors may exacerbate bleomycin-related pulmonary toxicity. 11 However, 2 well-conducted studies, a retrospective review 12 and a prospective clinical trial, 13 have failed to substantiate this suspicion. Neutrophil growth factors should be used sparingly in the management of Hodgkin lymphoma 14 ; however, when they are necessary, there is no need to avoid them due to concern over coincident use of bleomycin.…”

Section: Risk Factors Intrinsic To the Patientmentioning

confidence: 99%

Risk assessment in the management of newly diagnosed classical Hodgkin lymphoma

Connors

2015

Blood

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Treatment of Hodgkin lymphoma is associated with 2 major types of risk: that the treatment may fail to cure the disease or that the treatment will prove unacceptably toxic. Careful assessment of the amount of the lymphoma (tumor burden), its behavior (extent of invasion or specific organ compromise), and host related factors (age; coincident systemic infection; and organ dysfunction, especially hematopoietic, cardiac, or pulmonary) is essential to optimize outcome. Elaborately assembled prognostic scoring systems, such as the International Prognostic Factors Project score, have lost their accuracy and value as increasingly effective chemotherapy and supportive care have been developed. Identification of specific biomarkers derived from sophisticated exploration of Hodgkin lymphoma biology is bringing promise of further improvement in targeted therapy in which effectiveness is increased at the same time off-target toxicity is diminished. Parallel developments in functional imaging are providing additional potential to evaluate the efficacy of treatment while it is being delivered, allowing dynamic assessment of risk during chemotherapy and adaptation of the therapy in real time. Risk assessment in Hodgkin lymphoma is continuously evolving, promising ever greater precision and clinical relevance. This article explores the past usefulness and the emerging potential of risk assessment for this imminently curable malignancy.

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“…BLM is thought to react with Fe2+ to produce superoxide (02-), which damages DNA molecules and gives rise to pulmonary dysfunction (Sausville et al, 1978). According to Bastion et al (1994), who conducted two randomized placebo-controlled trials in NHL patients to assess the effectiveness of G-CSF, chemotherapy including BLM given in combination with G-CSF did not augment the pneumotropic toxicity of bleomycin. Another clinical study assessed pulmonary disease in patients with aggressive NHL who received BACOP (bleomycin, doxorubicin, cyclophosphamide, vincristine, prednisolone) therapy with or without G-CSF.…”

Section: Discussionmentioning

confidence: 99%

Interstitial pneumonia in patients receiving granulocyte colony-stimulating factor during chemotherapy: survey in Japan 1991-96

Niitsu

Iki²,

Muroi³

et al. 1997

Br J Cancer

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Summary Twenty cases of interstitial pneumonia secondary to treatment with granulocyte colony-stimulating factor (G-CSF) were reviewed. Their interstitial pneumonia had the following features: (a) it occurred predominantly in patients aged 60 years or older; (b) it was prevalent among patients with haematological malignancies, particularly non-Hodgkin's lymphoma; (c) in all patients G-CSF was given after anti-cancer agents with potential to affect the lungs; (d) at the onset, many patients had symptoms such as dyspnoea and fever; and (e) the leucocyte (neutrophil) count as well as lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels were usually higher than normal at the onset. These findings indicate that, when G-CSF is used in combination with pneumotoxic anti-cancer agents, respiratory function should be monitored before and during treatment. If the leucocyte (or neutrophil) count and/or LDH and CRP increase suddenly in association with dyspnoea and fever during administration of G-CSF, interstitial pneumonia should be suspected. Accordingly, a chest radiograph and pulmonary functional tests should be performed promptly. If a diagnosis of interstitial pneumonia is made, steroid pulse therapy should be commenced immediately.

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Possible toxicity with the association of G-CSF and bleomycin

Cited by 37 publications

References 3 publications

G-CSF (Filgrastim) as an Adjunct to MOPP/ABVD Therapy in Hodgkin's Disease

G-CSF (Filgrastim) as an Adjunct to MOPP/ABVD Therapy in Hodgkin's Disease

Risk assessment in the management of newly diagnosed classical Hodgkin lymphoma

Interstitial pneumonia in patients receiving granulocyte colony-stimulating factor during chemotherapy: survey in Japan 1991-96

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