Bleomisin tedavisi alan pediatrik onkoloji hastalarında solunum fonksiyonlarının değerlendirilmesi

Year 2025, Volume: 50 Issue: 1, 83 - 89, 31.03.2025

Emine Müge Özkan , Serhan Küpeli , Dilek Özcan , Ayşe Özkan , Gülay Sezgin , İbrahim Bayram

https://doi.org/10.17826/cumj.1573565

Abstract

Amaç: Bleomisin akciğer toksisitesine neden olan bir kemoterapötik ajandır. Bleomisin çoğunlukla çocukluk çağı kanserlerinde germ hücreli tümörler (GCT) ve Hodgkin Lenfoma (HL) tedavisinde kullanılır. Bu çalışmada akciğerde bleomisin toksisitesini erken dönemde tespit etmeyi amaçladık.
Gereç ve Yöntem: 2012-2022 yılları arasında Pediatrik Onkoloji kliniğine başvuran, GHT ve HL tanısı alan, 5 yaş ve üzeri, bleomisin tedavisi alan ve en az 6 aydır remisyonda olan hastaların akciğer fonksiyonları değerlendirildi. Solunum fonksiyonunun değerlendirilmesi öykü, fizik muayene, posteroanterior akciğer radyografisi ve solunum fonksiyon testine (SFT) dayanıyordu.
Bulgular: Takibe alınan ve yaşayan GHT'li hasta sayısı 59, HL'li hasta sayısı 89 idi. Bleomisin tedavisi alan, en az 6 aydır remisyonda olan, ulaşılabilen ve SFT yapılan hasta sayısı HL için 46, GHT için 12 idi. SFT anormalliği olan 21 hasta vardı. Bu hastaların 3'üne GHT, 18'ine HL tanısı konmuştu. Hastaların çoğunda SFT anormalliğinin türü restriktif bozukluktu.
Sonuç: SFT anormalliği olan hastaların %90'ında solunum semptomlarının olmaması, asemptomatik hastalarda SFT'nin önemini göstermektedir. Tedavinin bir parçası olarak bleomisin alan hastalar da geç pulmoner toksisite açısından takip edilmelidir.

Keywords

Akciğer toksisitesi, bleomisin, germ hücreli tümör, Hogkin lenfoma, akciğer fonksiyon testi

Assessment of respiratory functions in pediatric oncology patients receiving bleomycin treatment

Abstract

Purpose: Bleomycin is a chemotherapeutic agent that causes lung toxicity. Bleomycin is mostly used in the treatment of germ cell tumors (GCT) and Hodgkin Lymphoma (HL) in childhood cancers. In this study, we aimed to detect bleomycin toxicity to the lung in the early period.
Materials and Methods: Pulmonary functions of patients aged 5 years and older who were admitted to the Division of Pediatric Oncology with GCT and HL between 2012 and 2022, who received bleomycin treatment and were in remission for at least 6 months were evaluated. The evaluation of respiratory functions was based on history, physical examination, posteroanterior chest radiography (chest X-ray) and pulmonary function test (PFT).
Results: The number of patients with GCT who entered follow-up and lived were 59, those with HL were 89. The number of patients who received bleomycin treatment, were in remission for at least 6 months, could be reached and underwent PFT were 46 for HL and 12 for GCT. There were 21 patients with PFT abnormalities. Of these patients, 3 were diagnosed with GCT and 18 were diagnosed with HL. The type of PFT abnormality in the majority of patients was restrictive disorder.
Conclusion: The absence of respiratory symptoms in 90% of patients with PFT abnormalities shows the importance of PFT in asymptomatic patients. Patients who have received bleomycin as part of treatment should also be followed-up for late pulmonary toxicity.

Keywords

Lung toxicity, bleomycin, germ cell tumor, Hodgkin lymphoma, pulmonary function test

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