Which chemotherapy agent is known to lead to pulmonary fibrosis?

Bleomycin is the chemotherapy agent associated with the development of pulmonary fibrosis. This drug is an antineoplastic antibiotic derived from the bacterium Streptomyces verticillus. It interacts with DNA and causes breaks, which leads to cell death. A well-documented side effect of bleomycin is its ability to cause lung toxicity, primarily manifested as pulmonary fibrosis.

The pathophysiology behind bleomycin-induced pulmonary toxicity involves oxidative stress and inflammation that result in lung tissue damage. Patients receiving bleomycin can experience a range of pulmonary issues, from mild pneumonitis to severe fibrosis, which can significantly impact respiratory function.

While other chemotherapy agents can have pulmonary side effects, such as doxorubicin (which may lead to toxicity linked to anthracycline-induced heart issues) or taxanes (which might rarely cause allergic reactions or related symptoms), neither is known for causing pulmonary fibrosis as consistently as bleomycin. Cyclophosphamide has been associated with interstitial lung disease in high doses, but it is not characteristically linked to pulmonary fibrosis in the same way as bleomycin. Therefore, bleomycin is distinct in its association with this serious pulmonary complication.