RISK-FACTORS FOR REDUCED PULMONARY-FUNCTION AFTER MALIGNANT-LYMPHOMA IN CHILDHOOD

The aim was to study pulmonary function after Hodgkin disease ar non-H odgkin lymphoma in childhood and to evaluate ii younger age at diagnos is and therapy is a risk factor for reduced pulmonary function. We stu died a population-based sample of survivors oi Hodgkin disease (n = 22 ) or non-Hodgkin lymphoma (n = 19)in childhood, Pulmonary function tes t results were compared with reference values for our laboratory, gene rated by adjusting published reference values to fit 348 healthy never -smokers from a local population study Data were analysed as standardi sed residuals, which are [observed minus predicted value] divided by t he residual standard deviation of the reference equations. At a median of 11 years alter diagnosis (range 2 to 24), the participants had sig nificantly reduced lung volumes and transfer factor, unrelated to the few pulmonary symptoms. On average, the total lung capacity was reduce d to -0.9 standardised residual and the transfer factor was reduced to -1.3 standardised residual, Young age at therapy seemed to be a risk factor for reduced lung function, especially when treatment included t horacic irradiation. No significant toxic synergism was observed betwe en smoking and previous cancer therapy. Therapy without thoracic irrad iation but with doxorubicin and cyclophosphamide was almost as toxic t o lung function as therapy with thoracic irradiation but without doxor ubicin and cyclophosphamide, This suggests a pulmonary toxicity oi dox orubicin or cyclophosphamide. in conclusion, lung volumes and transfer factor were reduced several years after childhood Hodgkin disease or non-Hodgkin lymphoma, with young age at therapy as a risk factor, espe cially when combined with thoracic irradiation. (C) 1998 Wiley-Liss, I nc.