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n.

An antibiotic that is obtained from cultures of the bacterium Streptomyces verticillus and used in the form of its sulfate for the treatment of various neoplasms.

[Alteration of phleomycin, a related antibiotic : phleo-, of unknown meaning + –MYCIN.]

Key Terms: DNA.

Definition

Bleomycin (Blenoxane) kills cancer cells by damaging the genetic material known as DNA, thus preventing cells from repairing themselves.

Purpose

Bleomycin is used in the treatment of a number of different cancers, including cancer of the head and neck, skin, esophagus, lung, testis, penis, vulva, cervix, and genitourinary tract. In addition, it is used in the treatment of Hodgkin's disease and non-Hodgkin's lymphomas. It may also be used to treat Kaposi's sarcoma.

Because bleomycin is used in the treatment of so many different cancers, only a sampling of its uses can be provided here. In the treatment of Hodgkin's disease, one chemotherapy regimen used is the so-called ABVD, which consists of doxorubicin, bleomycin, vinblastine, and dacarbazine. Another regimen is called MOPP/ABV, which consists of mechlorethamine, vincristine, prednisone, procarbazine, doxorubicin, bleomycin, and vinblastine.

A treatment used for stage III and IV non-Hodgkin's lymphoma is the CHOP-bleomycin regimen, which consists of cyclophosphamide, hydroxydaunomycin, vincristine, prednisone, and bleomycin. Another approach to the same illness involves the m-BACOD chemotherapy regimen, which consists of methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone. Yet another approach to treating this disease is called ProMACE-CytaBOM, and consists of cyclophosphamide, doxorubicin, etoposide, prednisone, cytarabine, bleomycin, vincristine, methotrexate, and leucovorin.

Description

Bleomycin is an antitumor antibiotic that fights cancer by attacking the DNA in cancerous cells, thus interfering with cell growth.

Recommended Dosage

A dose of 0.25-0.50 units/kg (10-20 units per square meter) is given once or twice a week either intravenously, intramuscularly, or subcutaneously. A small test dose should be given first to test for a possible severe allergic reaction.

Precautions

Patients who receive certain forms of oxygen therapy while taking bleomycin or who receive anesthesia while taking bleomycin are at increased risk for developing serious lung problems.

Patients given bleomycin may develop an acute allergic reaction that may be fatal in rare cases. Therefore, a patient should only receive a small test dose of bleomycin the first time the drug is administered. After this initial dose the patient is observed carefully for one hour. Assuming no further problems appear, the patient may then receive a standard dose.

The likelihood that lung damage will occur increases if a patient receives more than 450–500 units of the drug during an entire lifetime. So, it is prudent to limit the amount of this medication given. Furthermore, it may be unwise to give bleomycin in regimens containing cyclophosphamide, as this combination also increases the likelihood that lung damage will occur.

Side Effects

Lung problems are a serious side effect affecting some patients who receive bleomycin. While lung problems can appear regardless of how much of the medicine is given, they are more likely to appear if a patient receives more than a certain amount of the medicine—250 units according to some authorities and 450–500 units according to others. The appearance of a dry cough may indicate the development of lung problems. Lung damage can be assessed by measuring the rate at which the patient is able to transfer gas across the lung membranes (DLCO or diffusion lung capacity).

Other side effects of bleomycin may include skin problems and alteration of skin color, allergic reactions, Raynaud's phenomenon, and hair loss (alopecia). In addition, headache, and nausea and vomiting may occur. Rheumatoid arthritis may worsen during bleomycin therapy. Patients with testicular tumors who receive multiple chemotherapy agents including bleomycin may develop Raynaud's phenomenon and cardiovascular disease. Raynaud's phenomenon, which affects the fingers and toes, may involve pain, pale color, and abnormal sensation (for instance, burning or prickling).

Approximately 1 out of every 100 patients who takes bleomycin experiences a reaction that involves chills, fever, wheezing, low blood pressure, and mental confusion. Unlike many other cancer drugs, bleomycin is not likely to cause any damage to the bone marrow.

Patients may be given steroids before bleomycin therapy is started in an effort to reduce the side effects of the drug.

Interactions

Bleomycin is often given in combination with with other anticancer drugs, for example cisplatin, vinblastine, and etoposide. Such combinations have been found to be more effective than single drug therapy.

—Bob Kirsch

Brand names: Blenoxane®

Español:
• Inyección de bleomicina

Bleomycin injection

What is bleomycin injection?

BLEOMYCIN (Blenoxane®) is a chemotherapy used for treating many kinds of cancer including cervical cancer, head and neck cancer, lymphomas, and testicular cancer. Bleomycin can be used alone or in combination with other anti cancer medicines. Bleomycin is also used to stop fluid from gathering around your lungs (i.e., effusions) and to treat warts. Generic bleomycin injections are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• infection (bacterial, viral or fungal)
• kidney disease
• lung disease, especially fibrosis
• previous or are currently smoking tobacco
• previous radiation therapy
• Raynaud's disease
• an unusual or allergic reaction to bleomycin, other chemotherapy agents, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Bleomycin is for injection into a muscle or under the skin, or infusion into a vein. Many times there is a test dose before the full dose is given. Bleomcyin may also be given through a special tube into the cavity around your lungs. Sometimes bleomycin is injected into a wart. This drug is usually given in a hospital or clinic setting by a trained health care professional.

What if I miss a dose?

It is important not to miss a dose. Let your prescriber or health care professional know if you are unable to keep an appointment.

What drug(s) may interact with bleomycin?

• certain antibiotics given by injection
• cisplatin
• cyclosporine
• diuretics (water pills)
• foscarnet
• vaccines

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking bleomycin?

Visit your prescriber or health care professional for regular checks on your progress.

Bleomycin may make you feel generally unwell. This is not uncommon because bleomycin affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Call your prescriber or health care professional for advice if you get a fever, chills or cough after you have been given the medicine. Chills can be common during bleomycin administration and will be treated by your prescriber if needed. Do not treat yourself.

Avoid smoking while you are receiving bleomycin. Smoking can increase the risk of serious lung damage.

Men and women of childbearing age should use effective birth control methods during bleomycin treatment. There is a risk of birth defects if a woman becomes pregnant and is being treated with bleomycin. Women should not become pregnant while being treated with idarubicin or if their partner is being treated with bleomycin.

If you are going to have surgery, tell your prescriber or health care professional that you are receiving or have received bleomycin.

What side effects may I notice from receiving bleomycin?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• chest pain
• confusion
• cough
• difficulty breathing, wheezing
• feeling faint
• fever
• skin rash, hives
• unusual tiredness or weakness
• vomiting

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• chills
• darkened, discolored skin
• hair loss
• itching
• loss of appetite
• malaise or feeling tired
• nail changes
• nausea
• tender, painful skin, at the injection site

Where can I keep my medicine?

This does not apply. You will not be given this medicine to take at home.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

A polypeptide antibiotic mixture having antineoplastic properties, obtained from cultures of Streptomyces verticellus. Evidence indicates that bleomycin inhibits cell division, thymidine incorporation into DNA, and DNA synthesis. Has been used in dogs and cats in the treatment of squamous cell carcinoma, but side-effects, including pneumonia or pulmonary scarring, limit its use.

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