Beyond conventional therapy: role of pulse steroids in bleomycin induced lung injury.

Bleomycin is an anti-neoplastic agent with potential for producing pulmonary toxicity, attributed in part to its freeradical-promoting ability. The central event in the development of toxicity is endothelial damage of the lung vasculature due to bleomycin-induced cytokines and free radicals, ultimately progressing to lung fibrosis. The treatment is discontinuation of bleomycin, initiation of systemic glucocorticoid therapy, and carefully titrating supplemental oxygen. Once the conventional therapy fails and the requirement of oxygen increases, pulse steroids have been associated with clinical, physiological, and radiographic resolution of bleomycin-induced lung disease.