Death due to interstitial pneumonia associated with bleomycin
10.3760/cma.j.cn114015-20220328-00257
- VernacularTitle:博来霉素诱发间质性肺炎致死亡
- Author:
Bingli QI
1
;
Yanli MA
;
Shikai LIU
Author Information
1. 河北省沧州市中心医院妇科肿瘤外三科，沧州 061001
- Publication Type:Journal Article
- Keywords:
Bleomycin;
Pneumonia;
Lung diseases, interstitial;
Ovarian neoplasms
- From:
Adverse Drug Reactions Journal
2022;24(12):670-672
- CountryChina
- Language:Chinese
-
Abstract:
A 51-year-old patient with yolk sac tumor received BEP regimen [intramuscular injection of bleomycin 30 mg, on day 2, 9, and 16), IV infusions of etoposide 100 mg/(m 2· d) and cisplatin 20 mg/m 2 on day 1 to 5] after comprehensive staging surgery for ovarian cancer, 21 days was a cycle. No interstitial changes in her lungs were found on chest CT before operation and before each chemotherapy cycle. On the 12th day of the 4th treatment cycle, the patient developed cough, expectoration. Laboratory tests showed white blood cell count 0.63×10 9/L, neutrophil count 0.16×10 9/L, hemoglobin 82 g/L, platelet count 42×10 9/L. Chest CT showed a little grid shadow in both lungs. The patient was diagnosed with myelosuppression (grade Ⅳ) and pulmonary infection. Bleomycin treatment in the 3rd week of the 4th cycle was stopped. Granulocyte colony stimulating factor, thrombopoietin, meropenem, bromhexine, blood transfusion, fluid infusion, and other symptomatic and supportive treatment were given. Bone marrow suppression was relieved, but cough and expectoration were aggravated. Chest CT showed a little grid shadow in both lungs. Glucocorticoid and amphotericin B were added, and non-invasive ventilator assisted ventilation and other symptomatic support treatments were given, but the patient′s condition worsened, and respiratory failure and death occurred 45 days after the 4th cycle of chemotherapy.
