Factors affecting the pulmonary toxicity of bleomycin.

Bleomycin induced lung toxicity was retrospectively analyzed in 39 patients with vulval malignancy (group A) and in 23 patients with head and neck carcinoma (group B). Group A consisted of non-smokers, mean age 69.8 years, who received the drug as intravenous injections. Group B contained mainly heavy smokers, mean age 60.6 years, treated with intramuscular injections of bleomycin. In group A, 6 patients (15.4%) and in group B only one patient (4.3%) developed typical pulmonary fibrosis. Advanced age, a high total dose of bleomycin, and intravenous bolus injections of the drug seemed to be major factors responsible for the development of lung fibrosis, whereas smoking had no obvious effect.