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Pulmonary function in children treated for rhabdomyosarcoma

E Kaplan1, C Sklar, R Wilmott

  • 1Division of Pulmonary Medicine, Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Medical and Pediatric Oncology
|August 1, 1996
PubMed
Summary

Rhabdomyosarcoma treatment, including bleomycin, can cause lung injury. Pulmonary function tests revealed significant restrictive ventilatory impairment and reduced lung function in most patients, especially those diagnosed over 8 years old.

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Area of Science:

  • Pediatric Oncology
  • Pulmonology
  • Toxicology

Background:

  • Rhabdomyosarcoma treatment has improved survival but can lead to lung damage.
  • Bleomycin, a chemotherapy agent, is known for its potential pulmonary toxicity.
  • Assessing pulmonary function in treated patients is crucial due to potential long-term effects.

Purpose of the Study:

  • To evaluate pulmonary function in patients treated for rhabdomyosarcoma, particularly those who received bleomycin.
  • To identify potential pulmonary dysfunction and risk factors associated with rhabdomyosarcoma therapy.

Main Methods:

  • Pulmonary function tests (PFTs) were administered to 17 patients treated for rhabdomyosarcoma.
  • Key PFT parameters assessed included total lung capacity (TLC) and carbon monoxide diffusing capacity (DLCO).

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  • Forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio and FEF25-75 were analyzed, with comparisons based on age at diagnosis.

    • Main Results:

    • 87% of patients exhibited restrictive ventilatory impairment (low TLC).
    • 70% showed reduced carbon monoxide diffusing capacity (low DLCO).
    • Patients diagnosed over 8 years old had significantly lower FEV1/FVC ratios and FEF25-75 compared to younger patients.

    Conclusions:

    • Rhabdomyosarcoma survivors treated with chemotherapy, including bleomycin, have a high incidence of restrictive lung abnormalities.
    • Age at diagnosis appears to influence the severity of certain pulmonary function deficits.
    • Pre- and post-treatment pulmonary function testing is recommended for monitoring lung health in these patients.