Pulmonary dysfunction in childhood Hodgkin lymphoma survivors: An
observational study
Abstract
Background: Childhood cancer survivors are 8.8 times more likely to die
of pulmonary causes when compared to general population: an aspect of
concern. Pulmonary dysfunction is the third leading cause of non
recurrence related cause of death among Hodgkin lymphoma survivors.
Methods: A cross section study on Hodgkin lymphoma survivors in complete
remission, who completed treatment within last 5 years was done. All
children were subjected to detail history including drugs, past history
of respiratory illnesses, physical and respiratory system examination
followed by spirometry and three minute step test under supervision.
Pulmonary dysfunction was determined as presence of obstructive,
restrictive or mixed pattern on spirometry or abnormality in three
minute step test. Subclinical pulmonary dysfunction was determined as
patients who were clinically asymptomatic but had pulmonary dysfunction
Results: A total of 60 children were enrolled (Mean age of 11.3 years
and 53 were boys) Abnormal pulmonary function tests were documented in
11 (18.3%) of HL survivors at a median time of 2 years (IQR 1,3) from
treatment completion. Restrictive pattern was documented in 10 (16.67%)
and obstructive pattern in only one patient (1.67%), mostly mild in
severity. Older age at start of chemotherapy and radiotherapy and past
history of respiratory illness were found to be significantly associated
with pulmonary dysfunction. Conclusion: Majority of Hodgkin lymphoma
survivors had subclinical pulmonary dysfunction at median follow up of 2
years from treatment completion. Hodgkin lymphoma survivors require long
term follow up for timely detection of pulmonary dysfunction and improve
quality of life.