BLEOMYCIN-INDUCED CHANGES IN THE CARBON-MONOXIDE TRANSFER-FACTOR OF THE LUNGS AND ITS COMPONENTS

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Abstract
To study subclinical pulmonary toxicity of bleomycin, the single-breath CO transfer factor (TLCO) and its components, pulmonary capillary blood volume (Vc), diffusing capacity of the alveolar-capillary membrane (Dm), and vital capacity (Vc) were measured in a homogenous group of 18 patients with testicular nonseminomatous germ cell tumor treated with bleomycin, vinblastine and cis-diammine-dichloroplatinum (DDP). The most prominent finding was a substantial decrease in Vc (P < 0.001) with only minor, though significant, changes in the other parameters. No recovery of pulmonary function had taken place 4 mo. after the last dose of bleomycin. The importance of correcting TLCO for Hb concentration is shown. Vascular damage may be an important feature of subclinical pulmonary injury caused by bleomycin given in combination with vinblastine and DDP. In the postbleomycin phase, other forms of potentially lung-toxic treatment should be instituted with care.