Cisplatin-induced changes in bleomycin elimination

Bleomycin disposition was studied in two children who received at least six courses of vinblastine, bleomycin, and cisplatin. Total plasma clearance of bleomycin decreased from 39 to 18 ml/min/m2, while the terminal-phase half-life increased from 4.4 to 6.0 hrs since the cumulative cisplatin dose was greater than 300 mg/m2. In one patient, renal clearance of bleomycin decreased from 30 to 8.2 ml/min/m2. Changes in serum creatinine or BUN were not predictive of changes in bleomycin elimination.