Experts agree that in spite of the lack of evidence on the association of bleomycin with severe lung COVID disease, bleomycin should be avoided when possible and hematopoietic growth factors (G-CSF) should be co-administered to diminish the incidence of neutropenia and infection in all patients with germ cell tumor (GCT) receiving chemotherapy. This evidence concerns the gene CSF3 and Decreased total neutrophil count.