Eigen H, Wyszomierski D
Am J Pediatr Hematol Oncol. 1985 Spring;7(1):71-8.
The development of pulmonary side effects, especially pulmonary fibrosis, during treatment with bleomycin is well documented in adult oncology patients, but not in children. A report of fatal pulmonary fibrosis which developed after exposure to oxygen while under anesthesia in a 3-year-old boy treated with bleomycin exemplifies the problem. The prevention of long-term complications associated with bleomycin is especially important in children, since a child cured of a malignant neoplasm may enjoy many years of productive life. Given the present limitations, guidelines for management of pediatric patients given bleomycin include: discontinuation of bleomycin therapy with the onset of symptoms; serial pulmonary function testing during the course of treatment; and early treatment with high-dose corticosteroids (prednisone 2 mg/kg/day) if symptoms occur.
博来霉素治疗期间肺部副作用尤其是肺纤维化的发生在成年肿瘤患者中有充分记录，但在儿童中却没有。一名接受博来霉素治疗的3岁男孩在麻醉状态下吸氧后发生致命性肺纤维化的报告例证了这一问题。预防与博来霉素相关的长期并发症在儿童中尤为重要，因为治愈恶性肿瘤的儿童可能享有多年的健康生活。鉴于目前的局限性，博来霉素治疗儿科患者的管理指南包括：出现症状时停用博来霉素治疗；治疗期间进行系列肺功能测试；如果出现症状，早期使用大剂量皮质类固醇（泼尼松2 mg/kg/天）治疗。
