What are the risk factors for pulmonary complications of Hodgkin lymphoma (Hodgkin disease) therapy?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The ABVD regimen contains bleomycin, a drug associated with dose-related pulmonary toxicity, mainly interstitial pneumonitis, which may lead to fibrosis. The addition of mantle irradiation enhances lung injury. Pulmonary symptoms, such as cough or dyspnea on exertion, are observed in 50% of patients. Declining pulmonary function is observed in approximately one third of patients during ABVD chemotherapy, with or without radiation therapy. This may necessitate dose reductions or even discontinuation of bleomycin.

Although acute toxicity is common, the incidence of severe long-term pulmonary toxicity is low. Fatal pulmonary toxicity has been reported in up to 2-3% of patients treated with the ABVD regimen.


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