What is a key adverse effect of bleomycin that requires monitoring?

Bleomycin is an antitumor antibiotic commonly used in the treatment of various cancers, including Hodgkin's lymphoma and testicular cancer. One of the most significant adverse effects associated with bleomycin is pulmonary toxicity. This adverse effect can manifest as pneumonitis or pulmonary fibrosis, which can lead to serious respiratory complications.

Monitoring for early signs of pulmonary toxicity is crucial because patients may develop respiratory distress, which may not be immediately apparent in the early stages. Typical symptoms include cough, dyspnea, and decreased oxygen saturation. The risk of pulmonary toxicity is dose-dependent and may be exacerbated by factors such as prior lung disease, increased age, or the use of oxygen therapy.

Myelosuppression, while a concern with many chemotherapeutic agents, is not a prominent side effect of bleomycin. Nausea and vomiting are seen with various chemotherapeutics but are not typically the primary concern with bleomycin. Hyperpigmentation may occur as a skin reaction to bleomycin but does not carry the same level of risk as pulmonary toxicity. Therefore, recognizing and monitoring for pulmonary toxicity is critical in patients receiving bleomycin therapy.