Methods
All biopsy proven HL survivors of age 6-18 years, within 5 years of
treatment completion and in complete remission attending Pediatric
cancer survivor clinic (PCSC) at tertiary care center in New Delhi were
enrolled for the study. The demographic details of the patients,
clinical pulmonary symptoms (chronic cough, breathlessness), grade of
dyspnea according to Modified Medical research council (mMRC scale) past
history of respiratory illness (asthma/recurrent nebulisations in the
past/ tuberculosis/pneumonia), treatment history including chemotherapy
related- regimen used (ABVD/BEACOPP), number of cycles, cumulative dose
of bleomycin, cyclophosphamide, Adriamycin and dacarbazine, radiotherapy
related-site, dose and fraction of radiation received, disease related
history (primary presentation, site of involvement, bulky disease, stage
and B symptoms) were recorded in a structured proforma. A detailed
physical examination was done for all patients, Vitals (including SpO2)
and anthropometry were recorded in detail. Nutritional status was
assessed. Respiratory system examination was done in detail. Relevant
investigations including hemogram at the time of evaluation, and
previous echocardiography findings of ejection fraction was collected.
Pulmonary function was evaluated by spirometry and 3 minute step test.
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
on spirometry or three minute step test