Systemic toxicity following intracavitary administration of bleomycin

Bleomycin administered intrapleurally has been demonstrated to be an effective sclerosing agent. The lack of morbidity associated with its use has made it an attractive alternative to other available agents. Pharmacologic data indicate that (1) intracavitary bleomycin is systemically absorbed, and (2) the plasma half-life of bleomycin increases exponentially with renal failure. We report the findings in a patient with renal failure who experienced alopecia and significant mucositis following sclerotherapy. We suspect this systemic toxicity resulted from intrapleural bleomycin and suggest that this treatment be used with caution in patients with renal dysfunction.