title: Late pulmonary complications of treating Hodgkin lymphoma: bleomycin-induced toxicity.
abstract: BACKGROUND
  Survival of Hodgkin lymphoma (HL) patients has significantly improved in recent decades. The current first-line therapy is doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) ± irradiation and may cause pulmonary toxicity. Strategies to reduce late toxicity as well as increase survival rate are of interest.
  
  
  METHODS
  Pulmonary function of previously treated HL patients was collected over a 12-month period using St. George Respiratory Questionnaire (SGRQ), chest X-ray, dynamic inhalation lung scintigraphy and spirometry.
  
  
  RESULTS
  A total of 137 patients' data were reviewed. Median time elapsed since diagnosis was 11 years (range was 2 - 30 years). Chest irradiation did not significantly worsen pulmonary function. Number of ABVD cycles with consequential bleomycin dose showed significant correlation with SGRQ total score in patients receiving ABVD plus chest irradiation (p = 0.01). Scintigraphy results correlated with bleomycin dose in patients receiving ABVD without chest irradiation (right side: p = 0.099, left side: p = 0.051).
  
  
  CONCLUSIONS
  An additive negative effect of chest irradiation was not confirmed as reflected in the literature; however, increasing cumulative bleomycin dose worsened pulmonary function.
authors.affiliation: University of Debrecen, Clinical Center, Division of Hematology, Institute for Internal Medicine and Department of Pulmonology , Nagyerdei krt. 98, H-4032 Debrecen , Hungary +36 52 411 717/56619 ; jona.adam1@gmail.com.
authors.forename: Ádám
authors.initials: Á
authors.lastname: Jóna
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Miltényi
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Ujj
authors.forename: Ildikó
authors.initials: I
authors.lastname: Garai
authors.forename: Mária
authors.initials: M
authors.lastname: Szilasi
authors.forename: Árpád
authors.initials: Á
authors.lastname: Illés
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin
keywords: Hodgkin lymphoma; bleomycin; pulmonary side effect; scintigraphy