Late Cardio-Pulmonary Sequelae after Treatment of Hodgkin’s Disease (HD)

HODGKIN’S disease patients regularly attending the paediatric oncology clinic of National Cancer Institute (NCI), Cairo University were studied to identify the late effects of radio- chemotherapy on the pulmonary and cardiovascular system in long-term survivors (LTS). A group of 42 LTS were studied, together with 26 newly-diagnosed (ND) HD patients and 28 healthy controls, during a 3 years period. The systolic and diastolic blood pressure-mean difference from the 90th percentile of age and sex-matched groups were higher in LTS and ND patients (P< 0.051 and P< 0.003, respectively). Systolic hypertension occurred in 9.5% of the LTS patients. Serum triglycerides (TG) were significantly elevated in LTS & ND patients (p 0.001). Anaemia was significantly higher in ND patients. Pulmonary infiltrations were detected in 4.8% of LTS, and 2.3% had plural thickening. One patient only (2.38%) of the LTS had constrictive pericarditis. Finally, the study documented that systolic hypertension, and a cardio-pulmonary complication was one of the long-term sequelae of radio-chemotherapy in HD patients. Recommendations regarding the follow-up of therapy for HD were discussed. New strategies and evidence-based surveillance of the long-term effects will be needed for dealing with HD, especially in children.