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Pulmonary dysfunction in childhood Hodgkin lymphoma survivors: An observational study
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  • Praneetha Mude,
  • Rachna Seth,
  • Jagdish Meena,
  • Aditya Gupta,
  • Sushil Kabra,
  • Sumita Gupta,
  • SN Dwivedi,
  • Devasenathepathy Kandasamy
Praneetha Mude
AIIMS

Corresponding Author:praneethanaik96@gmail.com

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Rachna Seth
All India Institute of Medical Sciences
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Jagdish Meena
All India Institute of Medical Sciences
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Aditya Gupta
Childrens Hospital at Westmead
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Sushil Kabra
AIIMS
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Sumita Gupta
All India Institute of Medical Sciences
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SN Dwivedi
All India Institute of Medical Sciences
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Devasenathepathy Kandasamy
AIIMS
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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.