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Chemotherapy and Radiation Induced Pulmonary Dysfunction in Hodgkin Lymphoma Patients

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Although the deterioration in pulmonary functions is a well-known important problem due to the treatment of the Hodgkin’s lymphoma patients, the immediate and long term effects of the therapy and its distinctive components were not shown clearly yet. We planned to investigate effects of multiple agent chemotherapy and/or radiotherapy to pulmonary functions immediately and thereafter and the possible effects of the managing this situation. 34 patients were included the study. The patients were evaluated for peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1), forced expiratory vital capacity (FVC), mean total lung capacity (TLC) values, FEV1/FVC ratio, diffusing capacity for carbonmonoxide (DLco), diffusing capacity for carbonmonoxide corrected for hemoglobin concentration (DLCO) before and at 1, 6 and 12 months after the initiation of the treatment. Demographic characteristics; disease stages; chemotherapy protocols; whether radiotherapy is received; if yes, the region and the dose received were recorded. The tests were finally analysed in two separated groups; group A treated with only chemotherapy and group B; treated with combination therapy, chemotherapy and radiotherapy. In group A, FVC and FEV1 is similar before and after treatment. FEV1/FVC ratio was increased (P = 0.0001) in this group despite increasing in mean TLC values (P = 0.001). No meaningful changes were observed in PEF and DLCO values in group A. In group B, FVC, FEV1 and PEF were decreased after treatment (for FVC P = 0.028, for FEV1 P = 0.04). Despite a decrease in first month of the treatment in FEV1/FVC ratio and DLco these two parameters were recovered at the end of the first year in group B patients. TLC values were increased after treatment in group B as in group A (P = 0.035). We believe that, if these patients are managed well in 1 year; necessary precautions are provided; and patients are well-informed, then there wouldn’t be too much risk and mortality rate for long-term side effects of ABVD and mediastinal RT.

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References

  1. Klimm B, Engert A, Diehl V (2006) First-line treatment of Hodgkin’s lymphoma. Curr Hematol Malig Rep 1(1):51–59

    Article  PubMed  Google Scholar 

  2. Lanzkowsky P (2005) Manuel of pediatric hematology and oncology, 4th edn. Elsevier Inc., Amsterdam, pp 453–490

    Book  Google Scholar 

  3. Josting A, Franklin J, May M, Koch P, Beykirch MK, Heinz J, Rudolph C, Diehl V, Engert A (2002) New prognostic score based on treatment outcome of patients with relapsed Hodgkin’s lymphoma registered in the database of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 20:221–230

    Article  PubMed  Google Scholar 

  4. Zubrod CG, Ipsen J, Frei E, Lasagna LC, Lipsett MB, Gehan E, Escher GC (1960) Newer techniques and some problems in cooperative group studies. Natl Cancer Inst Monogr 3:277–292

    CAS  PubMed  Google Scholar 

  5. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655

    Article  CAS  PubMed  Google Scholar 

  6. Cosset JM, Henry-Amar M, Meerwaldt JH (1991) Long-term toxicity of early stages of Hodgkin’s disease therapy: the EORTC experience. EORTC Lymphoma Cooperative Group. Ann Oncol 2(Suppl 2):77–82

    Article  PubMed  Google Scholar 

  7. Straus DJ (1995) High-risk Hodgkin’s disease prognostic factors. Leuk Lymphoma 15(Suppl 1):41–42

    Article  PubMed  Google Scholar 

  8. Hagberg H, Killander A, Simonsson B (1983) Serum β-2 microglobulin in malignant lymphoma. Cancer 51(12):2220–2225

    Article  CAS  PubMed  Google Scholar 

  9. Santoro A, Bonadonna G, Valagussa P, Zucali R, Viviani S, Villani F, Pagnoni AM, Bonfante V, Musumeci R, Crippa F (1987) Long-term results of combined chemotherapy-radiotherapy approach in Hodgkin’s disease: superiority of ABVD plus radiotherapy versus MOPP plus radiotherapy. J Clin Oncol 5(1):27–37

    CAS  PubMed  Google Scholar 

  10. Lagrange JL, Thyss A, Caldani C, Héry M, Schneider M, Bensadoun JR (1988) Toxicity of a combination of ABVD chemotherapy and mediastinal irradiation for Hodgkin’s disease patients with massive initial mediastinal involvement. Bull Cancer 75(8):801–806

    CAS  PubMed  Google Scholar 

  11. Jules-Elysee K, White DA (1990) Bleomycin-induced pulmonary toxicity. Clin Chest Med 11(1):1–20

    CAS  PubMed  Google Scholar 

  12. Evens AM, Helenowski I, Ramsdale E, Nabhan C, Karmali R, Hanson B, Parsons B, Smith S, Larsen A, McKoy JM, Jovanovic B, Gregory S, Gordon LI, Smith SM (2012) A retrospective multicenter analysis of elderly Hodgkin lymphoma: outcomes and prognostic factors in the modern era. Blood 119(3):692–695

    Article  CAS  PubMed  Google Scholar 

  13. Horning SJ, Adhikari A, Rizk N, Hoppe RT, Olshen RA (1994) Effect of treatment for Hodgkin’s disease on pulmonary function: results of a prospective study. J Clin Oncol 12(2):297–305

    CAS  PubMed  Google Scholar 

  14. Bates NP, Williams MV, Bessell EM, Hudson GV, Hudson BV (1994) Efficacy and toxicity of vinblastine, bleomycin, and methotrexate with involved-field radiotherapy in clinical stage IA and IIA Hodgkin’s disease: a British National Lymphoma Investigation pilot study. J Clin Oncol 12(2):288–296

    CAS  PubMed  Google Scholar 

  15. Hirsch A, Vander Els N, Straus DJ, Gomez EG, Leung D, Portlock CS, Yahalom J (1996) Effect of ABVD chemotherapy with and without mantle or mediastinal irradiation on pulmonary function and symptoms in early-stage Hodgkin’s disease. J Clin Oncol 14(4):1297–1305

    CAS  PubMed  Google Scholar 

  16. Salloum E, Tanoue LT, Wackers FJ, Zelterman D, Hu GL, Cooper DL (1999) Assessment of cardiac and pulmonary function in adult patients with Hodgkin’s disease treated with ABVD or MOPP/ABVD plus adjuvant low-dose mediastinal irradiation. Cancer Invest 17(3):171–180

    Article  CAS  PubMed  Google Scholar 

  17. Villani F, Fede Catania A, Laffranchi A, Maffioli L, Viviani S, Bonfante V (2003) Effect of an intensive chemotherapy followed by mediastinal irradiation on pulmonary and cardiac function in advanced Hodgkin’s disease. Cancer Invest 21(2):185–192

    Article  CAS  PubMed  Google Scholar 

  18. Ho P, Sherman P, Grigg A (2012) Intermittent granulocyte colony-stimulating factor maintains dose intensity after ABVD therapy complicated by neutropenia. Eur J Haematol 88(5):416–421

    Article  CAS  PubMed  Google Scholar 

  19. Villani F, De Maria P, Bonfante V, Viviani S, Laffranchi A, Dell’oca I, Dirusso A, Zanini M (1997) Late pulmonary toxicity after treatment for Hodgkin’s disease. Anticancer Res 17(6D):4739–4742

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Hematology, Medical Faculty, Istanbul Kemerburgaz University, Istanbul, Turkey

    Sebnem Izmir Guner

  2. Department of Medical Oncology, Medical Faculty, Istanbul Kemerburgaz University, Istanbul, Turkey

    Mustafa Teoman Yanmaz

  3. Department of Pulmonary Medicine, Medical Faculty, Istanbul Kemerburgaz University, Istanbul, Turkey

    Ahmet Selvi

  4. Department of Medical Oncology, Istanbul Research and Training Hospital, Istanbul, Turkey

    Cigdem Usul

  5. Department of Hematology and Bone Marrow Division, Istanbul Kemerburgaz University Medicalpark Bahçelievler Hospital, Kultur Sok. No. 1, Bahcelievler, 34160, Istanbul, Turkey

    Sebnem Izmir Guner

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  1. Sebnem Izmir Guner
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  2. Mustafa Teoman Yanmaz
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  3. Ahmet Selvi
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  4. Cigdem Usul
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Correspondence to Sebnem Izmir Guner.

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Guner, S.I., Yanmaz, M.T., Selvi, A. et al. Chemotherapy and Radiation Induced Pulmonary Dysfunction in Hodgkin Lymphoma Patients. Indian J Hematol Blood Transfus 32, 431–436 (2016). https://doi.org/10.1007/s12288-015-0619-x

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  • DOI: https://doi.org/10.1007/s12288-015-0619-x

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