Bleomycin A6

Summary

Bleomycin A6 is a member of the bleomycin family of antineoplastic glycopeptides, predominantly used in China and some Asian markets. It is structurally similar to bleomycin A2 and B2 (the principal components of the Western bleomycin sulfate formulation) but differs in its terminal amine substituent. Like other bleomycins, it is used in the treatment of squamous cell carcinomas, lymphomas, and testicular carcinomas. It is notable for relative bone marrow sparing but carries significant pulmonary toxicity risk.

Mechanism of Action

Bleomycin A6 is a copper-chelating glycopeptide that intercalates into DNA and, upon binding ferrous iron and oxygen, generates free radicals that cause single- and double-strand DNA breaks, leading to cell death. It inhibits DNA synthesis and causes G2/M cell cycle arrest.

Routes of Administration

Goals & Uses

• Lymphoma treatmentOncologyModerate
• Testicular carcinoma treatmentOncologyModerate
• Hemangioma treatmentDermatology/PediatricsLow
• Squamous cell carcinoma treatmentOncologyModerate
• Vascular malformation sclerotherapyInterventional RadiologyModerate

Contraindications

• Severely impaired renal functionRenalHigh
• Hypersensitivity to bleomycin compoundsImmunologicHigh
• PregnancyPopulationHighPotential fetal risk or insufficient safety data
• Pulmonary fibrosis or severe lung diseasePulmonaryHigh

Adverse Effects

• Oral mucositis / stomatitisMucosalUncommon
• Fever and chillsConstitutionalCommon
• Nausea and vomitingGastrointestinalUncommon
• Anaphylactoid reactionImmunologicRare
• Pulmonary toxicity / pulmonary fibrosisPulmonaryUncommon
• Mucocutaneous toxicity (skin thickening, hyperpigmentation, alopecia)DermatologicCommon

Drug Interactions

• Supplemental oxygen (high FiO2)High
• G-CSF / GM-CSFModerate
• CisplatinHigh
• Vinca alkaloids (vincristine, vinblastine)Low

Population Constraints

• Pediatric patientsAgeRelative
• Pregnant or breastfeeding womenReproductiveAbsolute
• Patients with renal impairmentOrgan ImpairmentRelative
• Elderly patients (≥65 years)Age RelatedRelative

Regulatory Status

• European UnionUnapprovedEMA-approved bleomycin products contain A2/B2 fractions; A6 as a standalone is not separately approved.
• United StatesUnapprovedBleomycin A6 as a distinct entity is not FDA-approved. US-approved bleomycin sulfate contains predominantly A2 and B2 components.
• United KingdomUnapprovedMHRA approvals cover bleomycin sulfate (A2/B2); Bleomycin A6 not separately licensed.

Bleomycin A6 (as 'Boanmycin' or Pingyangmycin) is approved in China by the NMPA for clinical use in cancer treatment. The Western bleomycin sulfate formulation (predominantly A2/B2) is FDA- and EMA-approved; A6 is not separately approved in the US or EU as a distinct entity.

Evidence & Sources

No sources recorded yet.