Observations

[Biren Saraiya]

We just recently have had a patient (Indian) who was admitted  with pulmonary infiltrates.  He has a history of Hodgkins disease and was treated with ABVD (adriamycin, bleomycin, vincristine and decadron).  Though no definitive diagnosis has been made, bleomycin pulmonary toxicity is considered a high in the list of differential (and most likely). 

 

The interesting observation is that this is a second male from India who has been admitted with similar presentation and diagnosed with bleomycin pulmonary toxicity.

 

Why is this important?  At least in the oncology world --- one of the frontiers is selecting dosing for drugs based on specific mutations.  Is there a specific genetic mutation that makes these patients more susceptible to pulmonary toxicities?   Are there specific mutations that might suggest better response? 

 

I only have specific information on the currently admitted patient, but not the other patient. 

 

Thoughts? 

 

Biren