# Cardiopulmonary function and cerebral blood flow in Hodgkin Lymphoma survivors

> **NIH NIH R21** · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · 2024 · $239,921

## Abstract

PROJECT ABSTRACT
Hodgkin Lymphoma (HL) is a cancer whose principal therapies are associated with an increased risk for
cardiopulmonary complications and cerebrovascular disease when compared to sibling. Reduced
cardiopulmonary functional reserve and lung morbidity are associated with poor neurocognitive outcomes. The
pathophysiology of how HL treatment and cardiopulmonary complications are related to increased
cerebrovascular and neurocognitive risks are not well understood. We hypothesize that impaired regulation of
cerebral blood flow (CBF), which is primarily driven by oxygen and carbon dioxide levels in the blood, is
caused by impaired gas diffusion in the lungs and reduced cardiopulmonary function and functional reserve.
The specific aims of this research are: 1) to evaluate how CBF and oxygenation change during exercise in
survivors compared to controls; 2) to examine if CO2 clearance differs in survivors compared to controls during
rest and exercise; and 3) to examine associations among CBF, reduced cardiopulmonary functional reserve,
cardiopulmonary function, and neurocognitive outcomes in HL survivors.
This study will utilize a cross-sectional assessment of community controls and adult survivors of HL who were
treated with bleomycin and/or chest and neck radiation. Participants will be recruited from the St. Jude Lifetime
Cohort (SJLIFE) study. As part of this study, they will undergo complete pulmonary function tests,
echocardiogram, and neurocognitive testing. In addition to this standard testing, CBF will be assessed
immediately prior to and during cardiopulmonary exercise using a wearable, near infrared spectroscopy
system. Participants will complete maximal (100% of predicted heart rate) cardiopulmonary exercise testing
with continuous 12-lead electrocardiogram (ECG) monitoring. Expired gas will be collected with a two-way non-
rebreather valve and monitored continuously using a breath-by-breath gas analysis system to evaluate
cardiopulmonary functional reserve and lung ventilation and gas diffusion measures. Demographic and
treatment factors will be compared to cardiopulmonary functional reserve outcomes. Gas diffusion
(ETCO2/DLCO) and CBF will be compared between HL survivors and community controls and identified
differences will be referenced to the chemotherapy, chest and neck radiation dose, pulmonary function test,
ECG, and neurocognitive testing. This study will improve our understanding of the relationship between
cardiopulmonary health and functional reserve, CBF regulation, and late-onset neurocognitive impairments in
HL survivors. This can be translated to improved screening and monitoring, and development of interventions
to reduce cancer related late-effects.

## Key facts

- **NIH application ID:** 10785926
- **Project number:** 1R21CA280230-01A1
- **Recipient organization:** ST. JUDE CHILDREN'S RESEARCH HOSPITAL
- **Principal Investigator:** Nicholas S Phillips
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $239,921
- **Award type:** 1
- **Project period:** 2024-01-08 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10785926

## Citation

> US National Institutes of Health, RePORTER application 10785926, Cardiopulmonary function and cerebral blood flow in Hodgkin Lymphoma survivors (1R21CA280230-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10785926. Licensed CC0.

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