Bleomycin is a mixture of cytotoxic glycopeptide antibiotics isolated from a strain of Streptomyces verticillus.

Indications: squamous cell carcinoma, lymphomas (Hodgkin’s disease, non-Hodgkin’s lymphoma); testicular carcinoma.

Cautions: in patients with significant impairment of renal function or compromised pulmonary function. Because of the possibility of an anaphylactoid reaction (idiosyncratic reaction), lymphoma patients should be treated with 2 units or less for the first two doses. If no acute reaction occurs, then the regular dosage schedule may be followed.

Contra-indications: pregnancy & breast feeding

Side effect: Pulmonary toxicities in 10% of the treated patients (pneumonitis progresses to pulmonary fibrosis).

An idiosyncratic reaction in 1% of the lymphoma patients treated with bleomycin has been reported. It consists of hypotension, mental confusion, fever, chills and wheezing (anaphylactic reaction).