The Role of Hypertension and Renin-angiotensin-aldosterone System Inhibitors in Bleomycin-induced Lung Injury |
| |
| Authors: | Ryujiro Hara Makoto Onizuka Sawako Shiraiwa Kaito Harada Yasuyuki Aoyama Daisuke Ogiya Masako Toyosaki Rikio Suzuki Sinichiro Machida Ken Ohmachi Yoshiaki Ogawa Hiroshi Kawada Shigeki Watanabe Akira Miyajima Ryota Masuda Masayuki Iwazaki Mikio Mikami Takashi Koike Kiyoshi Ando |
| |
| Institution: | 1. Division of Hematology/Oncology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan;2. Department of Hematology, Ebina General Hospital, Ebina, Kanagawa, Japan;3. Department of Urology, Tokai University School of Medicine, Isehara, Kanagawa, Japan;4. Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan;5. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa, Japan;6. Department of Pediatrics, Tokai University School of Medicine, Isehara, Kanagawa, Japan;1. Division of Hematology/Oncology, Department of Medicine, UCSF Medical Center, San Francisco, CA;2. UCSF Helen Diller Family Comprehensive Cancer Center, UCSF Medical Center, San Francisco, CA;3. Department of Hematology, Intermountain Healthcare, Salt Lake City, UT;4. Medical Science Liaison, Adaptive Biotechnologies, Seattle, WA;5. Department of Radiology, UCSF Medical Center, San Francisco, CA;6. Department of Epidemiology and Biostatistics, UCSF Medical Center, San Francisco, CA;1. Sydney Kimmel Cancer Center, Johns Hopkins Medical Institutions, Tucson, AZ;2. Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, MD;3. Department of Dermatology, Boston University and Roger Williams Medical Center; Department of Pathology and Laboratory Medicine, Brown University Alpert Medical School, Providence RI;1. Department of Medical Oncology, Olivia Newton-John Cancer Research and Wellness Center, Austin Hospital, Heidelberg, Australia;2. Eastern Health, Melbourne, Australia;3. University of Melbourne, Melbourne, Australia;4. Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia;5. Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia;1. Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China;2. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China;1. School of Medicine, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Mexico;2. Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;3. Institute of Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX;4. Division of Cancer Medicine, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX;5. Section of Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX |
| |
| Abstract: | IntroductionThe risk factors for bleomycin-induced lung injury (BLI), a fatal complication of cancer chemotherapy, are not well-established. The renin-angiotensin-aldosterone system (RAAS) has recently been suggested to play a role in the development of lung injury. This study clarified the impact of hypertension (HTN) and the administration of RAAS inhibitors on BLI occurrence in patients treated with bleomycin-containing regimens.Patients and MethodsWe retrospectively analyzed the data of 190 patients treated with a bleomycin-containing regimen for Hodgkin lymphoma or germ cell tumors at our institutions from 2004 to 2018.ResultsOverall, 190 patients received bleomycin, and symptomatic BLI occurred in 21 (11.1%) cases. In the multivariate analysis, age ≥ 65 years (odd ratio, 10.90; 95% confidence interval, 3.72-32.20; P < .001) and history of HTN (odds ratio, 3.32; 95% confidence interval, 1.07-10.30; P = .04) were found to be significant risk factors for BLI onset. BLI occurred in 3.6% (n = 5) of patients with no risk, 11.8% (n = 2) of those whose only risk factor was HTN, 31.6% (n = 6) of those whose only risk factor was age ≥ 65 years, and 57.1% (n = 8) of those with both risk factors (P < .001). BLI-induced mortality rates in each group were 0.0% (n = 0), 5.9% (n = 1), 10.5% (n = 2), and 42.9% (n = 6) (P < .001), respectively. Among 31 patients with HTN, BLI incidence was 12.5% in patients who were administered RAAS inhibitors and 53.3% in those who were not (P = .02).ConclusionOlder age and history of HTN were independent risk factors for the development of BLI, and the administration of RAAS inhibitors might reduce the onset of BLI. |
| |
| Keywords: | Germ cell tumors Hodgkin lymphoma Mediastinal tumor Ovarian tumor Testicular tumor |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
