Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Pediatric oncology

Background/purpose Long-term Hodgkin Lymphoma (HL) survivors are at risk of developing a range of therapy-related complications that may present 10 -15 years after treatment. The primary goal of study is to estimate the frequency of late effects and to determine risk factors that may contribute to this. Methods We performed a cross-sectional study on HL survivors{u2019} who were treated at National Cancer Institute, Cairo or Children Cancer Hospital Egypt 57357 with ABVD chemotherapy ± radiotherapy with a minimum 5 years follow up. Results Two hundred and eight patients were candidate. The cumulative incidence (CI) of cardiac toxicity (CT) at 5 and 9 years was 18.7% ± SD 2.7 and 43.3% ± SD 4.4, respectively. Preexisting cardiac abnormalities, cumulative anthracycline dose and end of treatment cardiac status are a strong predictor for late cardiotoxicity. Hypertension, was observed in about 31% of HL survivors. Young age (prepuberty) and obesity at time of treatment are important factors for hypertension. Thyroid abnormalities developed with a 5-year CI of 2% (95% CI 0.6% - 4.9%) while at 9-years the CI was 27.9% (95% CI 19% - 36%). Neck radiation therapy and the percentage of thyroid gland exposed to radiation are important risk factors.Obesity, was observed in 36% of HL survivors. High body mass index and older age (post-puberty) at the initial presentation are significant factors for obesity during the follow up. Endocrine hypogonadism was present in 22.5% of male survivors and 38% of female survivors. Disturbance of menstrual cycles was XII present in about one-third of female survivors. Furthermore, exposure to radiation therapy was associated with higher risk of irregular menstrual cycles. Abnormal pulmonary function tests were found in 43% and restrictive pattern was the most common type. Secondary cancers were founded in 3 patients (1.4%)

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