Manjunath Irappa Nandennavar, (2012) A Prospective study of Changes in Pulmonary Function Tests and Diffusion Coefficient of Carbon Monoxide (DLCO) in Hodgkin Lymphoma and Germ cell tumor patients receiving Bleomycin containing chemotherapy. Masters thesis, Cancer Institute (WIA), Chennai.
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Abstract
INTRODUCTION: Bleomycin pulmonary toxicity has been quoted to range from 0-46% with a mortality of about 1-2%. Significant decline in PFTs (Pulmonary Function Tests) and DLCO (diffusion coefficient of Carbon monoxide) has been quoted to be predictive of Bleomycin induced lung injury. There are no published studies of PFTs and DLCO in Indian patients receiving bleomycin containing chemotherapy. AIM OF THE STUDY: This is a prospective study to document the changes in serial PFTs and DLCO and also features of bleomycin lung toxicity in patients with Hodgkin lymphoma and Germ Cell Tumors receiving bleomycin containing chemotherapy. MATERIALS AND METHODS: Between June 2010 and October 2011, all the patients with a diagnosis of Hodgkin Lymphoma, Germ cell tumors of Ovary and Testis who were more than 15 yrs of age receiving Bleomycin containing chemotherapy were included in the study. These patients were followed up until Feb 2012 so that at least one set of interim PFTs is obtained of the patients enrolled in the later part of study period. PFTs and DLCO were done at baseline, interim (approximately 80-100U of Bleomycin delivered), end of treatment and at 6 months follow up. RESULTS: 76 patients (52 male, 24 female) were studied. 53 had Hodgkin lymphoma, 16 had Testicular GCT and 7 had Ovary GCT. Median age: 27 yrs, Median Hemoglobin 11.6 gm% (5.6-`16.5 gm%), Median Creatinine 0.7mg% (0.5-1.1 mg%), Median cumulative dose of Bleomycin 180U (60-290U). The decline in serial DLCO and TLC values was not statistically significant. 10 (13%) had pulmonary toxicity. Dyspnea was the commonest symptom. Of these 10 patients, 3 didn’t have PFT DLCO decline, 2 had asymptomatic drop in DLCO. Pulmonary toxicity did not develop in 4 other patients who continued to receive bleomycin even though they had significant DLCO drop. Age>30 yrs was the only significant predictive factor. No patient died of bleomycin pulmonary toxicity. CONCLUSIONS: PFTs and DLCO alone are not predictive of Bleomycin Pulmonary toxicity. A combination of diligently looking out for pulmonary symptoms along with radiologic imaging and pulmonary function tests can pick up Bleomycin lung toxicity.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Bleomycin, Pulmonary function tests, Diffusion coefficient of Carbon monoxide, Bleomycin induced pulmonary toxicity. |
| Subjects: | MEDICAL > Medical Oncology |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2020 02:05 |
| Last Modified: | 29 Feb 2020 02:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11904 |
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