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Bleomycin

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDDRUG-BLEOMYCIN
TypeMédicament
Alias
BlénoxaneБлеоміцин
Étatpending_clinical_signoff
MaladiesDIS-CHL DIS-TESTICULAR-GCT
SourcesSRC-NCCN-BCELL-2025

Faits sur les drogues

CatégorieAntibiotique antitumoral glycopeptide
MécanismeGenerates free radicals causing DNA strand breaks. G2 cell-cycle phase active. Lung tissue lacks bleomycin hydrolase → accumulates → pulmonary toxicity.
Dose typiqueABVD: 10 USP units/m² IV days 1+15 of 28-day cycle. Cumulative lifetime limit ~400 USP units (pulmonary toxicity).
Ukraine enregistréeVrai
NSZU rembourséVrai
Ukraine vérifiée pour la dernière fois2026-04-27

Avertissements

Notes

Replaced in modern Hodgkin 1L by brentuximab vedotin (A+AVD per ECHELON-1) due to pulmonary toxicity. NEVER combine with brentuximab (additive lung toxicity). G-CSF is not routinely required with ABVD, but may be considered for subsequent cycles after treatment delays due to sepsis or other clinical factors; monitor for pulmonary toxicity. Compromised pulmonary function requires extreme caution and individualized assessment. For classical Hodgkin lymphoma, baseline PFT/DLCO selection and repeat testing depend on the applicable protocol; BSH does not recommend routine repeated PFTs. New respiratory symptoms require prompt clinical assessment. Communicate prior bleomycin exposure to anesthesia. Oxygen and fluid management require individualized assessment and adequate oxygenation; no blanket lifetime high-flow oxygen prohibition is established here.

Evidence for specific statements

These citations cover only the statements and scopes shown. They do not establish clinical approval of this record.

For bleomycin, 1 USP unit equals 1000 International Units under the eviQ convention. US product vials are labelled 15 or 30 units of Bleomycin for Injection USP. Confirm the formulation and unit system; milligram activity must not be treated as a generic mg-by-weight conversion.

Unit nomenclature and equivalence only; not individualized dosing, schedule selection, cumulative-risk elimination or whole-record clinical approval.

SRC-BLEOMYCIN-US-LABEL SRC-EVIQ-TESTICULAR-BEP-320 SRC-EVIQ-ABVD-56

US label Description/How supplied; eviQ 320 treatment schedule bleomycin equivalence footnote.

Growth-factor support is not routinely required with ABVD. It may be considered after treatment delays due to sepsis or other patient factors, with pulmonary monitoring. The US bleomycin label reports a possible interaction but states randomized clinical studies have not demonstrated increased pulmonary complications.

ABVD growth-factor selection and uncertainty of the pulmonary interaction only; no universal requirement, contraindication or reassurance of zero risk.

SRC-EVIQ-ABVD-56 SRC-BLEOMYCIN-US-LABEL

eviQ 56 v7 growth-factor note and haematological toxicity guidance; US bleomycin label Pulmonary adverse reactions.

Prior bleomycin exposure warrants communication with anesthesia and individualized pulmonary-risk, oxygen and fluid assessment. Label precautions favor lower oxygen concentrations, but observational evidence does not establish a universal ceiling or lifetime high-flow oxygen ban. Adequate oxygenation remains necessary.

Perioperative oxygen management only; observational findings do not prove absence of pulmonary risk or authorize unrestricted hyperoxia.

SRC-BLEOMYCIN-US-LABEL SRC-AAKRE-BLEOMYCIN-PERIOPERATIVE-2014

US label Pulmonary adverse reactions; Aakre 2014 Results/Discussion.

For classical Hodgkin lymphoma, BSH recommends selective baseline PFTs including DLCO when a further decline could be clinically important, and no routine repeated PFTs. Pre-existing lung disease requires individual risk assessment rather than a universal DLCO <40% absolute contraindication. eviQ ABVD 56 instead recommends baseline assessment and monitoring as clinically appropriate; its stopping criterion is DLCO below 30-35% of the pretreatment value, not a 25% decline and not percent predicted. New cough or dyspnoea needs prompt clinical assessment and chest CT when toxicity is suspected, considering infection and pulmonary embolism. PFTs alone do not establish toxicity. These protocol differences must not be merged into a universal numeric rule or permission to continue treatment until a threshold is reached.

Classical Hodgkin lymphoma pulmonary assessment only; not germ-cell regimen guidance, individualized treatment authorization, or whole-record approval.

SRC-BSH-CHL-BLEOMYCIN-2025 SRC-EVIQ-ABVD-56

BSH Table 1 recommendations 1.2, 2.5-2.6 and 4.2-4.5; eviQ 56 v7 Clinical information/Pulmonary toxicity and Dose modifications/Pulmonary toxicity.

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Contraindications

Protocole thérapeutique