Long-term pulmonary function in survivors of childhood Hodgkin disease and non-Hodgkin lymphoma

Pediatr Blood Cancer. 2007 Oct 15;49(5):699-703. doi: 10.1002/pbc.21175.

Abstract

Background: The aim of our study was to evaluate the long-term effects of chemotherapy and/or radiotherapy on lung function in 75 childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) survivors several years after treatment.

Patients and methods: We studied 37 HD and 38 NHL survivors. These patients were divided into two groups according to the treatment protocols applied. Group I consisted of 23 patients who were treated with both chemotherapy and thoracic irradiation and Group II consisted of 52 patients who were treated with chemotherapy and no thoracic irradiation. A detailed history of smoking habits, respiratory symptoms, and diseases was recorded. Complete physical examinations and pulmonary function tests [PFT, including spirometry, lung volume, and diffusion capacity for carbon monoxide (DLCO)] were performed on all subjects.

Results: No patients reported acute or chronic respiratory symptoms or diseases. Pulmonary function abnormality (reduced lung volume and diffusion capacity) was found in 13% of patients at a median 5 years after diagnosis. The percentage of predicted normal value of forced expiratory volume in the 1st sec (FEV(1)), residual volume (RV), and DLCO were significantly lower in Group I than these values for Group II. There were no significant differences in PFT parameters between patients with HD and NHL (P > 0.05). It appears that the risk of reduced lung function was greater the younger the patient in therapy.

Conclusion: Chemotherapy or chemo-radiotherapy-induced pulmonary sequalae in childhood may remain asymptomatic for many years.

MeSH terms

  • Age Factors
  • Antineoplastic Agents / adverse effects
  • Hodgkin Disease / complications*
  • Hodgkin Disease / therapy
  • Humans
  • Lung / physiopathology*
  • Lymphoma, Non-Hodgkin / complications*
  • Lymphoma, Non-Hodgkin / therapy
  • Radiotherapy / adverse effects
  • Respiratory Function Tests
  • Risk Factors
  • Survivors

Substances

  • Antineoplastic Agents