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.