Bleomycin - Uses - Dosages - Side Effects - Precautions

Bleomycin: Frequently Asked Questions Answered

What is Bleomycin?

Bleomycin belongs to the class of organic compounds known as hybrid glycopeptide. It is an antibiotics agent which exhibits antineoplastic activity and is used primarily in chemotherapy as an anticancer agent. Initially used as a single agent, it has now been used in combination in chemotherapy. Bleomycin inhibits the uncontrolled cell division in cancer-causing cells by inhibiting DNA synthesis. Bleomycin is therapeutically used to treat malignant neoplasms such as sarcomas, lymphomas, melanomas, and germinal cell cancers. Bleomycin should be used cautiously because of its associated toxicity.

What are the uses of Bleomycin?

Bleomycin is a glycopeptide class antibiotic that shows antitumor activity; hence it is classified as an ‘Anticancer antibiotic.’ Bleomycin is approved for use in adults and can be used alone or with other drugs as palliative treatment and management of malignant neoplasms. 

FDA approved therapeutic uses –

  • Squamous cell carcinoma
  • Gestational thromboplastin disease.
  • Germinal cell tumors. 
  • Hodgkin and Non-Hodgkin’s Lymphoma

Non -FDA approved therapeutic uses –

  • Malignant pleural effusions
  • Osteosarcoma
  • Melanoma
  • AIDS-associated Kaposi sarcoma
  • Advanced stages of Mycosis Fungoides.
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What are the side effects of Bleomycin?

The side effects of Bleomycin depend on the amount of drug administered. Most people will experience a range of side effects depending on the case. Most side effects are almost reversible and subside after the treatment is complete. 

  • Common side effects – Fever, chills, skin reactions, nail thickening and banding, hair loss.
  • Less common side effects – Nausea, vomiting, loss of appetite, weight loss, mouth sores, Phlebitis, lung issues like pneumonitis, and rarely fibrosis. 
  • Uncommon side effects – Vascular effects leading to heart attack or stroke, severe allergic reaction, Pulmonary fibrosis. 

Before the use of Bleomycin, consult your doctor. 

Consult with experts at Yashoda hospitals for doubts regarding cancer treatment.


Frequently Asked Questions about Bleomycin

1. How does Bleomycin work?

Cancerous cells are characterized by uncontrolled cell division. Unlike normal cells, cancer cells lose the ability to stop division. Drugs used in chemotherapy halts this division and kills cancer cells. Bleomycin interacts with cancerous cells and binds with the DNA, and inhibits cell synthesis by breaking DNA strands. It affects RNA and protein synthesis to a lesser degree; when the cells cannot divide, they die.

2. How long does Bleomycin stay in your system?

Bleomycin is administered via the parenteral route and is most quickly absorbed intramuscularly, subcutaneously, intraperitoneal, or intrapleural. Bleomycin reaches peak plasma concentration in 60 minutes, and the terminal half-life of the drug is around 3 hours, which varies based on patients and routes of administration. Mean plasma clearance approaching 70 mL/min/m2.

3. Is Bleomycin a targeted therapy?

Yes, Bleomycin is a targeted therapy. Targeted therapy is a cancer treatment that targets specific genes and proteins responsible for cancerous cell growth and survival. It affects the cells in different ways;

  • Blocks or turn off signals that tell cancer cells to grow and divide.
  • Prevent the cells from living longer than average.
  • Destroy cancer cells.
Despite being the most effective broad-spectrum chemotherapeutic agent in cancer treatment, Bleomycin has limited uses due to poor drug delivery abilities and toxicity.

4. Why does Bleomycin injection hurt?

Redness, pain, swelling, and burning sensation on the injection site are expected immediately after the injection. The pain may persist for up to 72 hours and usually responds to NSAIDs. In case of prolonged irritation and other skin reactions, it is advisable to consult your oncologist.

5. Is Bleomycin an antibiotic?

Bleomycin belongs to the glycopeptide class of antibiotics, which has been shown to have antitumor activity; hence it is classified as an anticancer antibiotic and is used to treat cancer. Most antibiotic antitumor drugs are cell-cycle nonspecific except Bleomycin which shows significant effects in G2 and M phases.

6. What is the mechanism of action for Bleomycin?

Bleomycin's primary mechanism of action is to oxidatively damage DNA by binding to metal ions, including iron, and forming metallic bleomycin complexes. It is believed that Bleomycin chelates metal ions to produce a pseudo-enzyme that reacts with the oxygen-producing superoxide and hydroxyl free radicals that cleave DNA. At higher concentrations, RNA and protein synthesis is also suppressed. A combined effect is attributed to its antineoplastic activity inhibiting the cell's uncontrolled cell division.

7. Is Bleomycin still used?

Yes, Bleomycin is used in combination as palliative therapy for the treatment of malignant neoplasms. Due to its life-threatening associated risks, side effects, and lung toxicity its is advised to consult your doctor before using Bleomycin. In cases of pre-existing lung issues and predisposition to severe lung problems in older patients, receiving higher doses can be life-threatening. Physician opinion is advised.

8. Is Bleomycin carcinogenic to humans?

There are no studies of Bleomycin alone, but a few case reports suggest exposure to Bleomycin in the presence of concurrent therapy with putative carcinogens such as ionizing radiation, alkylating agents, and other onco-therapeutic drugs may contribute to carcinogenic effects. While the studies still don't suggest a definitive answer, Bleomycin has shown chromosomal aberration in vitro.

9. What kind of drug is Bleomycin?

Bleomycin is an antibiotic that belongs to the class of Glycopeptide. Due to its antineoplastic activity, it is administered in anti-cancer treatment as a part of palliative care.

10. What does Bleomycin do to your lungs?

Due to its toxic effects on the lungs, it is recommended to consult your doctor before using Bleomycin. In patients with existing lung issues, it can exacerbate and can also cause pulmonary fibrosis in rare cases.

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