II. Indications

  1. See Intralesional Bleomycin
  2. Cervical Cancer
  3. Germ cell malignancy (children)
  4. Head and Neck Cancers
  5. Lymphoma
  6. Penile Cancer
  7. Squamous Cell Carcinoma
  8. Testicular Cancer
  9. Vulvar Cancer
  10. Miscellaneous
    1. Malignant Pleural Effusion (used intrapleural as a sclerosing agent)

III. Mechanism

  1. See Antibiotic Chemotherapy
  2. Bleomycin is a complex of Glycopeptide Antibiotics (A2, B2) extracted from the bacterium Streptomyces verticillus
  3. Bleomycin is a G2/M-Phase specific Antineoplastic Agent
  4. Bleomycin forms complexes with iron and reduces molecular oxygen to superoxide and hydroxyl free radicals
    1. Induces single and double stranded breaks in DNA
    2. Other effects
      1. Lipid peroxidation of cell membrane lipids (cytotoxic effects)
      2. Carbohydrate oxidation
      3. Alters Prostaglandin synthesis and degradation

IV. Medications

  1. Bleomycin Injection Powder for Solution: 15 unit and 30 unit vials

V. Dosing

  1. See other references for disease specific dosing protocols
  2. Limit initial dose to <=2 units for first 1-2 doses in Lymphoma patients
    1. Reduces risk of anaphylactoid reaction (see below)

VI. Adverse Effects

  1. Alopecia
  2. Dermatotoxicity
  3. Hepatotoxicity
  4. Nephrotoxicity
  5. Pulmonary Fibrosis
    1. Highest risk with Bleomycin lifetime cummulative exposure >400 units
  6. Anaphylactoid Reaction
    1. Altered Mental Status
    2. Chills
    3. Fever
    4. Hypotension
    5. Wheezing

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Chest XRays (for pulmonary fibrosis findings)

VIII. Drug Interactions

  1. Bleomycin decreases other drug levels
    1. Digoxin
    2. Phenytoin

IX. Resources

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Bleomycin (C0005740)

Definition (NCI) A basic glycopeptide antineoplastic antibiotic isolated from Streptomyces verticillus. Bleomycin antibiotics form complexes with iron that react with molecular oxygen to produce superoxide and hydroxyl free radicals, causing single- and double-stranded breaks in DNA. These reactive oxygen species also induce lipid peroxidation, carbohydrate oxidation, and alterations in prostaglandin synthesis and degradation.
Definition (NCI) A mixture of glycopeptide antineoplastic antibiotics isolated from the bacterium Streptomyces verticillus. Bleomycin forms complexes with iron that reduce molecular oxygen to superoxide and hydroxyl radicals which cause single- and double-stranded breaks in DNA; these reactive oxygen species also induce lipid peroxidation, carbohydrate oxidation, and alterations in prostaglandin synthesis and degradation.
Definition (NCI_NCI-GLOSS) The active ingredient in a drug that is used to treat many types of cancer and is being studied in the treatment of other types of cancer. It comes from the bacterium Streptomyces verticillus. Bleomycin damages DNA and may kill rapidly growing cancer cells. It is a type of antineoplastic antibiotic.
Definition (MSH) A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors.
Definition (CSP) complex of related glycopeptide antibiotics from Streptomyces verticillus; inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors.
Definition (PDQ) A mixture of glycopeptide antineoplastic antibiotics isolated from the fungus Streptomyces verticillus. Bleomycin forms complexes with iron that reduce molecular oxygen to superoxide and hydroxyl radicals which cause single- and double-stranded breaks in DNA; these reactive oxygen species also induce lipid peroxidation, carbohydrate oxidation, and alterations in prostaglandin synthesis and degradation. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39139&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39139&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C313" NCI Thesaurus)
Concepts Amino Acid, Peptide, or Protein (T116) , Antibiotic (T195)
MSH D001761
SnomedCT 391855008, 372843005, 76591000
English Bleomycins, bleomycin, Bleomycin [Chemical/Ingredient], blm, Bleomycin - chemical (substance), Bleomycin - chemical, Bleo, BLEOMYCIN, Bleomycin (product), Bleomycin (substance), Bleomycin, BLM, BLEO, Bleomycin Antibiotic
Swedish Bleomycin
Czech bleomycin
Finnish Bleomysiini
French Bléomycines, Bléomycine
Italian Bleomicine, Bleomicina
Russian BLEOMITSIN, БЛЕОМИЦИН
Japanese ブレオマイシン
Polish Bleomycyna
Spanish bleomicina (producto), bleomicina (sustancia), bleomicina, Bleomicina
German Bleomycin
Portuguese Bleomicina