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Bleomycin & oxygen

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  • #16
    The oxygen can trigger the fibrosis. Usually it is a reaction that occurs during treatment, but it can occur up to ten years (documentation so far) after treatment with Bleomycin. I'm not one to retain the chemical details in my brain, but essentially they beleive that the bleo is not cleared completely from the lungs and the oxygen precipitates the reaction. The reaction creates growing patches of fbrosis that become scar. The lung does not regenerate in that area. So far they treat with high dose steroids, but they are not sure really if or why steroids work. Because the reaction, if it does start can be fatal, they ususally move quickly. Hope this helps. If you have more questions I can try to find articles. This is not a reaction that is well understood. take care, Sharon
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    • #17
      Bleo Toxicity

      Hey guys,

      I need some insight into pulmonary infiltrates and my brain doesn't seem to be functioning too well since I find tons of stuff on the web but it doesn't seem relevant. This forum seems to be one of the few places where I've found good answers.

      Anyway, I had my IO 4/07, 4 BEP Summer '07 (at NYU) and an RPLND 4/08 (at MSKCC). The BEP left me with Bleo Toxicity which I think is the same as pulmonary infiltrates. My RPLND was postponed for about 6 months while they waited for the infiltrates to clear up (which the pulmonologist treated with prednisone).
      Since then, all my blood work, CXR and CT scans have been normal - except for the most recent (last week - I've been getting them every two monhts) CXR which showed an increase in infiltrates. Pulmonary function tests have been OK but the last one was 6+ months ago.

      I'm seeing the pulminologist next week, but I was hoping for some insight into this, such as:
      1. Why/how would it increase.
      2. What sort of complications could this lead to.
      3. What treatment options are available.

      Clearly these are all questions for the pulmonologist next week, but this has me freaked out now. Also, any insight would allow me to ask better questions and understand the answers better as well.



      • #18
        Maggio, I am interested in references supporting your statement about new research on bleomycin and oxygen. Please see my thread in this forum, as I would appreciate your input.


        • #19
          I just had a chest port operation yesterday. They connected oxygen through the blow tubes to my nose. I didn't have a mask nor did I have general anaesthesia. Do you think this was OK? I mentioned about bleo multiple times to the doctors. My lungs feel funny today.
          Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
          Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma, IVC Filter
          4*BEP AFP 20 end of 4*BEP
          May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
          Surveillance (blood & X rays) and all clear for 24 months
          April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
          4xTIP - almost normal AFP, but started rising again
          2 x HDC with Autologous Stem Cell Transplant - AFP almost normal but started rising again
          Lost kidneys, damaged liver, chirhosis, ascites 2 liters per day, dialysis 3 times per week, disabled
          2 Lung Wedge Resections -


          • #20
            So what if you have to have surgery that requires general anesthesia and you've had lung damage due to bleo? Say you had to have a gallbladder removed. I'm curious as to know what would you do then? Just hope it turns out okay?


            • #21
              If I understand the problem correctly, treatment with bleo does not preclude any sort of oxygen forever. However, your docs all need to be aware pf your history so that precautions can be taken to insure there are no problems. The bigger problem seems to be that many docs are simply unaware of the problems that *might* crop up with O2 administration, so just telling them you've had bleo might not be good enough protection.

              All of us bleo recipients should be ready to inform our docs about the potential problems (like print out an article or two), because this info seems to be not widely understood by most docs.

              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP