Bleomycin pharmacology in relation to adverse effects and renal function in cervical cancer patients

Clinical toxicity is related to bleomycin pharmacology and renal function in patients with advanced squamous carcinoma of the cervix. Adverse effects were more frequent in patients with severe renal impairment than in patients with adequate renal function. Pharmacokinetic data were obtained in four patients. This information suggests treatment guidelines for the use of bleomycin in patients with renal failure that may reduce the risk of excessive adverse effects. Bleomycin dose reduction of 75% and administration not more often than every 3 days may permit the use of this drug in patients with creatinine clearances of less than 25 ml/min in whom alternative chemotherapy with cis-platinum is not possible.