Evaluation of respiratory functions in pediatric oncology patients receiving bleomycin treatment

Purpose: Bleomycin is a chemotherapeutic agent that causes lung toxicity. It is mostly used in the treatment of germ cell tumors and Hodgkin lymphoma in childhood cancers. In this study, it has been aimed to determine the lung toxicity of bleomycin in the period before it causes lung toxicity due to bleomycin. Materials and methods: Respiratory functions of patients aged 5 years and older who applied to the Pediatric Oncology Department of our hospital with the diagnosis of germ cell tumor and Hodgkin lymphoma between 2012 and 2022 and received bleomycin treatment, were in remission for at least 6 months, were evaluated. The evaluation of pulmonary functions has been based on history, physical examination, posteroanterior chest X-ray and pulmonary function test. The files of all patients with a diagnosis of HL and GHT have been scanned. PFT has been performed on patients who have met the inclusion criteria, and patients with PFT disorders were given gender, age at diagnosis, current age, histopathological subtype, stage, chronic respiratory symptoms, smoking, chemotherapy protocol, cumulative bleomycin dose, radiotherapy, chest X-ray and thorax. were evaluated in terms of information on whether there was pathology in the computerized tomography. Results: There were 109 patients with a diagnosis of GHT and 122 patients with a diagnosis of HL. 15 of the patients with GHT and 17 of the patients with HL were removed because they were dead. 35 of 94 patients with a diagnosis of GHT had never been followed up. Of the 105 patients who lived with a diagnosis of HL, 16 were not followed up. The number of patients with GHT who were followed up and survived was 59, and the number of patients with HL who were followed up and survived was 89. The number of patients who received bleomycin treatment, was in remission for at least 6 months, could be reached, and underwent PFT was 46 for HL and 12 for GHT, a total of 58. There were 21 patients with PFT disorder. While 3 of these patients were diagnosed with GHT, 18 were diagnosed with HL. The type of PFT disorder in the majority of patients was restrictive disorder. Conclusion: The absence of respiratory tract symptoms in 90% of patients with PFT disorder indicates the importance of PFT in asymptomatic patients. Patients who have received bleomycin as part of treatment should also be monitored for late pulmonary toxicity.