The incidence of bleomycin induced lung toxicity is increased in Hodgkin lymphoma patients over 45 years exposed to granulocyte-colony stimulating growth factor^†

Abstract

In Hodgkin lymphoma (HL) bleomycin can induce pulmonary toxicity (BPT). BPT consists of respiratory tract symptoms during bleomycin-exposure and radiologic pulmonary lesions without concomitant infection. Older age, bleomycin dose, smoking history and the use of granulocyte-colony stimulating factor (G-CSF) have been suggested as possible risk factors for BPT. It is still debated whether BPT affects overall (OS) and progression-free survival (PFS). We investigated the incidence of BPT along with possible risk factors in 412 HL patients treated in 1990-2014. BPT occurred in 34 patients (8%) and was significantly associated with disseminated disease and B-symptoms. It was more frequent in elderly patients (p = .05) but not significantly correlated with a history of smoking. BPT occurred more often in patients receiving G-CSF (p = .03), particularly the poly-ethylenglycol-bound molecule. All significant risk correlations were limited to the age group >45 years. In the present cohort, BPT did not influence OS or PFS regardless of age.

Keywords:

• Hodgkin lymphoma
• bleomycin
• pulmonary toxicity
• prognosis

Acknowledgements

This work was supported by the Karen Elise Jensen Foundation; the Max and Inger Wørzner Foundation, The Foundation in Commemoration of Eva and Henry Fraenkel, The Foundation of Aase and Ejner Danielsen, The Foundation of Poul and Ellen Hertz, The Foundation of Else and Mogens Wedell-Wedellsborg and The A.P. Møller and Chastine Mc-Kinney Møller Foundation for General Purposes.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1515939.