Risk Factors For Impaired Pulmonary Function In Adult Survivors Of Childhood Hematological And Non-Hematological Malignancies

Treatment with chemotherapy and/or radiotherapy in children may adversely affect the respiratory system. The aim of this study was to evaluate long‐term lung function in adults who survived hematological and non- hematological malignancies in childhood. We performed standard spirometry and diffusion-lung CO (DLCO) in a group of 112 adults (58% males, age 18-37 yrs). The mean follow-up from therapy ending was 13±5 yrs. Previous diagnosis included: 53% acute leucocytic or lymphoblastic leukemia (AL), 23% Hodgkin, non-Hodgkin or Brurkitt lymphoma (LY), 24% nonhematological malignancy (NHM). None of the patients reported acute/chronic respiratory symptoms. Pulmonary function abnormality (FVC 79 to 34% and DLCO 76 to 60%) was found in 9.8 % of the patients (14% of patients with LY, 12% NHM, 10% AL). Generally, spirometric values and DLCO, in % of predicted, were significantly lower, P<0.05, in females (FVC 101±9 vs 96±12, FEV1 101±9 vs 93±1, DLCO 101±13 vs 96±11). Spirometric values and DLCO were also significantly lower in patients with LY compared to AL and NHM (fig 1). We conclude that although a minority of patients can develop asymptomatic functional impairment, long term pulmonary function is generally well preserved in survivors of childhood malignancies. Female sex and lymphoma are risk factors for functional abnormalities.