Introduction
In the current era, newer chemotherapeutic agents have drastically improved 5 year survival rate of Hodgkin Lymphoma (HL) to 90% (1). However these treatment advances are associated with long term effects of which pulmonary dysfunction is the third leading cause of nonrecurrence related cause of death among HL survivors (2). Pulmonary dysfunction seen in HL survivors can develop secondary to chemotherapy or radiotherapy (3). Bleomycin is a known pulmonary toxin among the chemotherapy drugs used in treatment of HL The possible mechanism of bleomycin induced lung injury include i) oxidative damage from reactive oxygen species leading to fatty acid oxidation ,membrane instability and inflammatory reactions in the lung. ii) relative deficiency of metabolizing enzyme bleomycin hydrolase in the lung iii) genetic susceptibility iv) elaboration of inflammatory cytokines (4). Radiation induced lung injury can be acute radiation pneumonitis or chronic radiation induced pulmonary fibrosis (5).
Most of the studies on pulmonary dysfunction in Hodgkin lymphoma survivors till date are conducted in adult population of childhood Hodgkin lymphoma survivors. (6). With respect to pulmonary dysfunction in HL survivors, there is paucity of literature regarding prevalence, clinical manifestations and pattern (obstructive/restrictive) of abnormalities in pulmonary function tests (2,7). The studies conducted so far on pulmonary dysfunction have been on heterogenous population (2,7). The present study was undertaken to evaluate the prevalence, spectrum and risk factors for occurrence of pulmonary dysfunction in Indian childhood survivors of Hodgkin lymphoma