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