Bleomycin A2
Also known as: Blenoxane, Bleocin, Bleomycin A2, Bleomycin sulfate, Bleomycin sulfate (major component), BLM A2, NSC-125066
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Summary
Bleomycin A2 is the major active component of the bleomycin mixture used intravenously as a chemotherapeutic agent for Hodgkin lymphoma, testicular cancer, squamous cell carcinoma of the head and neck, and other malignancies.
Mechanism of Action
Binds DNA and, in the presence of iron and oxygen, generates free radicals that cause single- and double‑strand DNA breaks leading to cell death.
Routes of Administration
Goals & Uses
- Testicular germ cell tumor treatmentOncologyHigh
- Testicular cancerOncologyHigh
- Hodgkin's lymphoma treatmentOncologyHigh
- Squamous cell carcinoma treatmentOncologyHigh
- Malignant pleural effusion sclerotherapyPalliative OncologyModerate
- Hodgkin lymphomaOncologyHigh
- Non-Hodgkin's lymphoma treatmentOncologyModerate
- Squamous cell carcinoma of head/neckOncologyHigh
Contraindications
- Known hypersensitivity to bleomycinImmuneHigh
- Significant pre-existing pulmonary diseasePulmonaryHigh
- PregnancyPopulationHighPotential fetal risk or insufficient safety data
- Hypersensitivity to bleomycinAllergy/immunologyHigh
- Severe renal impairment (CrCl <25 mL/min)RenalHigh
- Prior severe pulmonary toxicity from bleomycinPulmonaryHigh
- Severe pulmonary fibrosisRespiratoryHigh
Adverse Effects
- Pulmonary fibrosis / pneumonitisPulmonaryUncommon
- Mucocutaneous toxicity (skin thickening, hyperpigmentation, rash)DermatologicCommon
- Pulmonary toxicity (fibrosis, pneumonitis)RespiratoryCommon
- Fever and chillsConstitutionalCommon
- Nausea and vomitingGastrointestinalCommon
- MucositisGastrointestinal / MucosalUncommon
- Skin reactions (hyperpigmentation, erythema)DermatologicCommon
- Raynaud's phenomenonVascularUncommon
- Anaphylactoid reactionsImmunologicUncommon
Drug Interactions
- Live vaccinesHigh
- Supplemental oxygen (high FiO2)High
- Other pulmonary toxic agents (e.g., cyclophosphamide, methotrexate)Moderate
- CisplatinHigh
- Vinca alkaloids (vincristine, vinblastine)Moderate
- High inspired oxygen concentrationsHigh
- Granulocyte colony-stimulating factors (G-CSF)Moderate
Population Constraints
- SmokersLifestyleRelative
- Renal impairmentOrgan ImpairmentRelative
- Elderly patients (≥70 years)AgeRelative
- Pediatric patientsAgeRelative
- Patients requiring general anesthesiaProceduralRelative
- Patients with renal impairmentOrgan ImpairmentRelative
- Elderly patientsAgeRelative
Regulatory Status
- European UnionApprovedApproved: Hodgkin lymphoma, Testicular cancer, Head and neck cancers
- United StatesApprovedApproved: Hodgkin lymphoma, Testicular cancer, Squamous cell carcinoma of head and neck, Gestational trophoblastic diseaseAdministered as bleomycin sulfate injection
- United KingdomApprovedApproved: Hodgkin lymphoma, Testicular cancer, Head and neck cancers
Approved as part of the bleomycin sulfate mixture by the FDA. The mixture contains bleomycin A2 and B2 as primary components. Individual fractions are not separately approved but are covered under the bleomycin sulfate NDA. Cumulative dose limits (typically ≤400 units lifetime) are recommended to reduce pulmonary toxicity risk.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Bleomycin A2?
Bleomycin A2 is the major active component of the bleomycin mixture used intravenously as a chemotherapeutic agent for Hodgkin lymphoma, testicular cancer, squamous cell carcinoma of the head and neck, and other malignancies.
What is Bleomycin A2 used for?
Bleomycin A2 is educationally associated with: Testicular germ cell tumor treatment, Testicular cancer, Hodgkin's lymphoma treatment, Squamous cell carcinoma treatment, Malignant pleural effusion sclerotherapy, Hodgkin lymphoma, Non-Hodgkin's lymphoma treatment, Squamous cell carcinoma of head/neck. Educational only — not medical advice.
How is Bleomycin A2 administered?
Recorded routes of administration: Intracavitary, Intramuscular, Intratumoral, Intravenous, Subcutaneous.
What are the potential side effects of Bleomycin A2?
Reported adverse effects include: Pulmonary fibrosis / pneumonitis, Mucocutaneous toxicity (skin thickening, hyperpigmentation, rash), Pulmonary toxicity (fibrosis, pneumonitis), Fever and chills, Nausea and vomiting, Mucositis, Skin reactions (hyperpigmentation, erythema), Raynaud's phenomenon, Anaphylactoid reactions. This list is not exhaustive — consult a qualified clinician.
Who should avoid Bleomycin A2?
Recorded contraindications: Known hypersensitivity to bleomycin, Significant pre-existing pulmonary disease, Pregnancy, Hypersensitivity to bleomycin, Severe renal impairment (CrCl <25 mL/min), Prior severe pulmonary toxicity from bleomycin, Severe pulmonary fibrosis. Consult a qualified clinician before use.