Pulmonary toxicity in patients with advanced-stage germ cell tumors receiving bleomycin with and without granulocyte colony stimulating factor

Scott B. Saxman, Craig R. Nichols, Lawrence H. Einhorn

Research output: Contribution to journalArticle

53 Scopus citations


Study objectives: The purpose of this study is to determine whether co- administration of granulocyte colony stimulating factor (G-CSF) and bleomycin results in enhanced pulmonary toxicity compared with bleomycin alone. Design: A retrospective analysis comparing two groups of patients with advanced germ cell tumors receiving combination chemotherapy that includes bleomycin with or without G-CSF. Setting: Indiana University Medical Center. Patients: Group A consisted of 29 patients with advanced-stage germ cell tumors who were treated with combination chemotherapy that included bleomycin. All patients received concurrent prophylactic G-CSF. Group B consisted of 57 patients with advanced-stage germ cell tumors who were treated on a phase 3 study comparing standard BEP (bleomycin, etoposide, cisplatin) to BEP with twice the cisplatin dose. None of these patients received growth factor. Results: Of the 29 patients who received concurrent chemotherapy and G-CSF, ten (34%; 95% confidence interval [CI], 17.9 to 54.3%) were believed to have clinically significant bleomycin toxicity. Of the 57 patients who did not receive growth factor, 19 (33%; 95% CI, 21.4 to 47.1%) had bleomycin-related toxicity. There was no difference in the incidence of pulmonary toxicity between the groups (p = 1.00 by Fisher's Exact Test). Conclusions: There is no increase in pulmonary toxicity with co-administration of G-CSF and bleomycin compared to bleomycin alone in patients with advanced germ cell tumors.

Original languageEnglish (US)
Pages (from-to)657-660
Number of pages4
Issue number3
StatePublished - Jan 1 1997



  • bleomycin
  • germ cell tumors
  • granulocyte colony stimulating factor
  • pulmonary toxicity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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