Prospective study of the pulmonary toxicity of continuously infused bleomycin.

Bleomycin is an effective antitumor drug but must be used cautiously because of its pulmonary toxicity. We performed a prospective study of the effects on pulmonary function when bleomycin was given as a continuous iv infusion over a 7-day period. Bleomycin was administered at a dose of 15 units/m2 as an iv push followed by 15 units /m2/day as a continuous iv drip. Thirteen previously untreated patients completed the study after receiving a mean total dose of 228 units. Pulmonary function tests were performed before bleomycin treatment and periodically during the subsequent 6 months. There was a small mean increase in both vital and diffusing capacities after 6 months, which was not statistically significant. No patient had a serious loss in pulmonary function. We conclude that the risk of bleomycin toxicity is low when the drug is given at this dose by continuous infusion. The risk may be less than the risk of toxicity from bolus injection in this dose range.