Introduction:Bleomycin (bleo) containing first-line therapy ± irradiation may cause pulmonary toxicity in Hodgkin lymphoma (HL) patients. Patients and methods:Pulmonary function of newly diagnosed HL patients were assessed, by using St. George Respiratory Questionnaire (SGRQ), dynamic inhalation lung scintigraphy, diffusion capacity of the lung for carbon monoxide (DLCO) and spirometry before, during and after treatment, prospectively. Bleo hydrolase (BLMH) SNP A1450G genotype polymorphism was determined by TaqMan genotyping assay. Results:A total of 50 classical HL pts. data were available for analysis, treated between February 2012 and March 2016 in our Institution. 38 pts. received ABVD (median cumulative bleo dose: 120 mg/m2) chemotherapy, 18 pts. received bleo intramuscularly (im.) and 20 intravenously (iv.). As control group, 12 pts. were treated with brentuximab vedotin (BV)-AVD. Chest irradiation was involved in 11 pts.’ treatment. Pulmonary complains measured by SGRQ slightly improved over treatment. Lung scintigraphy results of bleo-treated pts. significantly worsened over treatment. More interestingly, results of BV-treated pts. not only significantly worsened over treatment, but was significantly inferior to bleo treated patients. By excluding smoker pts., difference became not significant, but still inferior to bleo treated pts. DLCO much less explicitly confirmed these results. Spirometry parameters improved over treatment in both groups, with no significant differences. Chest irradiation did not significantly worsen pulmonary function. Pts. receiving iv. bleo had significantly worse results measured with lung scintigraphy at the end of treatment and during treatment with DLCO, than those receiving im.. BLMH SNP A1450G didn’t distinguished in this short run of bleo treated pts.. Discussion:Pulmonary function test results of bleo treated pts. worsened over treatment as previously reported, however we found these results only with lung scintigraphy. DLCO was much less supportive. Moreover, only one patient was found with acute bleo induced lung injury in contrast with the literature (20-46%). Surprisingly, BV-AVD, which is considered non-pulmonary toxic, produced inferior results to bleo treated pts.. We have to compliment, that these results were only seen with lung scintigraphy, which has no literature, and data lacks of confirmation with gold-standard DLCO. Nevertheless, lung scintigraphy is supposed to measure earlier epithelial damage.