Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 11 4 2017 10 01 286 292 EN Adam Binder Montefiore Medical Center 111 East 210th Street Bronx, NY 10467 Sonia Rai Icahn School of Medicine at Mount Sinai 1 Gustave L Levy Place New York, NY 10029 Amir Steinberg Icahn School of Medicine at Mount Sinai 1 Gustave L Levy Place New York, NY 10029 2017 04 18 2017 10 01 Background: There is conflicting data about the increased risk of pulmonary toxicity when granulocyte-stimulating factor (G-CSF) is given in combination with bleomycin. No clear consensus for management of patients with Hodgkin lymphoma (HL) who require G-CSF support exists. Our objective was to evaluate whether there is an increase in pulmonary toxicity in patients who receive bleomycin and G-CSF during treatment for HL.  Materials and Methods: We conducted a single-center retrospective analysis of patients with Hodgkin Lymphoma from January 2003 until July 2015. All patients who received at least 1 dose of bleomycin and followed at our institution were included. Patients were evaluated for pulmonary toxicity starting from the day of first dose of bleomycin until 1 year after initiation of bleomycin. Data on pre-identified risk factors for pulmonary toxicity were also collected. Results: Fifty-four patients met inclusion criteria. Twenty-one patients received bleomycin alone, and 33 patients received bleomycin and G-CSF. There was no statistically significant (p = 0.50) difference in the development of pulmonary toxicity between the two groups. Crude hazard ratio for development of pulmonary toxicity in the bleomycin and G-CSF cohort was 1.58 (95% confidence interval, CI: 0.41-6.12). On multivariate analysis, the hazard ratio for development of pulmonary toxicity was 1.71 (95% CI: 0.43-6.81). Conclusion: This study does not find evidence that the combination of bleomycin and G-CSF increases the risk for bleomycin- induced pulmonary toxicity. We recommend G-CSF use in HL patients receiving bleomycin when needed to maintain dose intensity.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/776 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/776/578