Routine pulmonary function tests during bleomycin therapy. Tests may be ineffective and potentially misleading

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Abstract
Forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) studies in 2 patients with proved interstitial fibrosis after low doses of bleomycin were contrasted with these measurements in 21 patients who received bleomycin without toxicity. The FVC decreased significantly (20% or more) in both fibrosis patients and in 7 others. In 1 fibrosis patient and in 3 other the results could be explained by weakness. The DLCO fell in patients with fibrosis and in 12 others. Correction for decrease in Hb level accounted for the change in 1 of the toxic patients and 7 others, but Hb correction made 2 insignificant changes significant and increased therapy values above control 4 times. Since these tests have many false-positive results and can be affected by weakness and anemia leading to false-negative results their use is ineffective and may be misleading.