To Dive or Not to Dive with Bleomycin: A Practical Algorithm

Hulst, Rob A. van; Rietbroek, R. C.; Gaastra, Menno T W; Schlösser, N. J. J.

doi:10.3357/asem.2816.2011

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…3c). van Hulst et al 23 have published an algorithm to aid in risk stratification of scuba diving post-bleomycin and further advice can be sought from the UK Diving Medical Committee (www.ukdmc.org).…”

Section: Resultsmentioning

confidence: 99%

Development of a best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours in the UK

et al. 2018

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Bleomycin, a cytotoxic chemotherapy agent, forms a key component of curative regimens for lymphoma and germ cell tumours. It can be associated with severe toxicity, long-term complications and even death in extreme cases. There is a lack of evidence or consensus on how to prevent and monitor bleomycin toxicity. We surveyed 63 germ cell cancer physicians from 32 cancer centres across the UK to understand their approach to using bleomycin. Subsequent guideline development was based upon current practice, best available published evidence and expert consensus. We observed heterogeneity in practice in the following areas: monitoring; route of administration; contraindications to use; baseline and follow-up investigations performed, and advice given to patients. A best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours has been developed and includes recommendations regarding baseline investigations, the use of pulmonary function tests, route of administration, monitoring and patient advice. It is likely that existing heterogeneity in clinical practice of bleomycin prescribing has significant economic, safety and patient experience implications. The development of an evidence-based consensus guideline was supported by 93% of survey participants and aims to address these issues and homogenise practice across the UK.

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Section: Resultsmentioning

confidence: 99%

Development of a best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours in the UK

et al. 2018

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“…Very few medical reports have been published about diving after tumor therapy and these all deal with patients who have received intravenous chemotherapy, that is, bleomycin [26][27][28] and none deal with head and neck tumor patients. This is the first evaluation of scuba diving following head and neck cancer rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Scuba Diving After Extensive Head and Neck Reconstructive Surgery

Thiele

Knape

Mischkowski

et al. 2016

Journal of Craniofacial Surgery

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In the case described herein, the CT scans revealed tooth fragments embedded in the tongue. The parasagittal cuts revealed the anterior-posterior and slightly cranial-caudal direction of the fragments and the parasagital cuts revealed that the fragments followed a left to right direction. These findings allowed the precise localization of the foreign bodies and facilitated their removal from the lacerations in the tongue with the aid of a long hemostatic clamp without the need for incisions. FIGURE 3. Postoperative x-ray (orthopantomography) of the 3rd patient after surgical open bite correction with Le Fort 1 downfracture. FIGURE 2. Postoperative x-ray of the skull (posterior-anterior) of the second patient after open reduction and osteosynthesis of the panfacial fracture.

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“…Following the previous case reports, a theoretical risk of BPT induced by scuba diving was proposed. 14 While no reports of scuba diving-induced BPT have been published, there are conflicting opinions regarding the safety of scuba diving following treatment. 15 Some believe that scuba diving can be resumed 6-12 months following an uncomplicated 3-4 cycles of bleomycin, etoposide, and cisplatin (BEP) and advise caution for those patients who develop clinical signs of pulmonary impairment during or following bleomycin.…”

Section: Introductionmentioning

confidence: 99%

“…van Hulst et al created a practical algorithm to evaluate if patients treated with bleomycin were able to safely resume scuba diving. 14 The algorithm consisted of a series of tests including, a physical exam, fitness test, chest X-ray (CXR), and pulmonary function tests (PFTs). Sixteen patients previously treated with bleomycin were evaluated using the algorithm.…”

Section: Introductionmentioning

confidence: 99%

“…All three of the Hodgkin lymphoma patients who were considered unfit had previously received radiation to the thorax. 14 Since cytokines have a role in the development of BPT, it is hypothesized that the concurrent use of G-CSF, which elevates cytokine concentration, and bleomycin could increase the incidence of BPT. 2 Several case reports have been published associating G-CSF use with the development of BPT.…”

Section: Introductionmentioning

confidence: 99%

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The role of screening and monitoring for bleomycin pulmonary toxicity

Shippee¹,

Bates

Richards

2015

J Oncol Pharm Pract

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Bleomycin-induced pulmonary toxicity can have a significant impact on patient outcomes. However, no guidelines for ideal screening and monitoring are available. This paper reviews the literature to identify the best way to monitor and reduce patient risk for bleomycin pulmonary toxicity. We have created evidence-based guidelines to help healthcare professionals identify patient risk factors and provide appropriate assessment and monitoring for patients receiving bleomycin therapy.

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To Dive or Not to Dive with Bleomycin: A Practical Algorithm

Cited by 6 publications

References 6 publications

Development of a best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours in the UK

Development of a best-practice clinical guideline for the use of bleomycin in the treatment of germ cell tumours in the UK

Scuba Diving After Extensive Head and Neck Reconstructive Surgery

The role of screening and monitoring for bleomycin pulmonary toxicity

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