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Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 103-106

Beware of bleomycin toxicity: Fertility preservation for dysgerminoma

Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India

Correspondence Address:
Paapa Dasari
Department of Obstetrics and Gynaecology, WCH, JIPMER, Puducherry
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tofj.tofj_6_18

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An 18-year-old female who underwent fertility preservation surgery for dysgerminoma Stage IIa received adjuvant chemotherapy and bleomycin, etoposide and cisplatin of four cycles. She presented with cough and breathlessness after 45 days of the last cycle of chemotherapy. She was tachypneic and had decreased SpO2 and was managed by supportive therapy. Her X-ray chest revealed bilateral ground-glass nodular opacity and computed tomography thorax showed evidence of pulmonary fibrosis in the form of intra- and inter-lobular septal fibrosis with surrounding ground-glass opacity. She ultimately died after 5 days of admission due to respiratory failure. Her body weight was 37 kg and she received standard dose of bleomycin and the cumulative dose was 360 U. Bleomycin dose recommendation is not per kg bodyweight, and the complication of pulmonary fibrosis could have been prevented if the dosage schedule as per bodyweight (0.25–0.5 U/kg) is advocated.

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