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Clinical Significance of Pulmonary Function Tests in Long-Term Survivors after Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation

DOI: 10.4236/ojbd.2013.31002    3,534 Downloads   6,013 Views  

ABSTRACT

We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58; score 1, n = 14; score 2, n = 6; score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

K. Matsumoto, S. Ito, W. Yamamoto, E. Ogusa, A. Maruta, Y. Ishigatsubo and H. Kanamori, "Clinical Significance of Pulmonary Function Tests in Long-Term Survivors after Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation," Open Journal of Blood Diseases, Vol. 3 No. 1, 2013, pp. 6-12. doi: 10.4236/ojbd.2013.31002.

References

[1] A. O. Soubani, K. B. Miller and P. M. Hassoun, “Pulmonary Complications of Bone Marrow Transplantation,” Chest, Vol. 109, No. 4, 1996, pp. 1066-1077. doi:10.1378/chest.109.4.1066
[2] E. Sakaida, C. Nakaseko, A. Harima, A. Yokota, R. Cho, Y. Saito, et al., “Late-Onset Noninfectious Pulmonary Complications after Allogeneic Stem Cell Transplantation are Significantly Associated with Chronic Graft-versusHost Disease and with the Graft-versus-Leukemia Effect," Blood, Vol. 102, No. 12, 2003, pp. 4236-4242. doi:10.1182/blood-2002-10-3289
[3] A. Palmas, A. Tefferi, J. L. Myers, J. P. Scott, S. J. Swensen, M. G. Chen, et al., “Late-Onset Noninfectious Pulmonary Complications after Allogeneic Bone Marrow Transplantation,” British Journal of Haematology, Vol. 100, No. 4, 1998, pp. 680-687. doi:10.1046/j.1365-2141.1998.00617.x
[4] F. Patriarca, C. Skert, A. Sperotto, D. Damiani, M. Cerno, A. Geromin, et al., “Incidence, Outcome, and Risk Factors of Late-Onset Noninfectious Pulmonary Complications after Unrelated Donor Stem Cell Transplantation,” Bone Marrow Transplant, Vol. 33, No. 7, 2004, pp. 751-758. doi:10.1038/sj.bmt.1704426
[5] E. M. Gore, C. A. Lawton, R. C. Ash and R. J. Lipchik, “Pulmonary Function Changes in Long-Term Survivors of Bone Marrow Transplantation,” International Journal of Radiation Oncology, Biology, Physics, Vol. 36, No. 1, 1996, pp. 67-75. doi:10.1016/S0360-3016(96)00123-X
[6] P. Fulgoni, M. C. Zoia, A. Corsico, M. Beccaria, G. Georgiani, G. Bossi, et al., “Lung Function in Survivors of Childhood Acute Lymphoblastic Leukemia,” Chest, Vol. 116, No. 5, 1999, pp. 1163-1167. doi:10.1378/chest.116.5.1163
[7] T. K. Marras, C. K. Chan, J. H. Lipton, H. A. Messner, J. P. Szalai and A. Laupacis, “Long-Term Pulmonary Function Abnormalities and Survival after Allogeneic Marrow Transplantation,” Bone Marrow Transplant, Vol. 33, No. 5, 2004, pp. 509-517. doi:10.1038/sj.bmt.1704377
[8] B. N. Savani, A. Montero, C. Wu, N. Nlonda, E. Read, C. Dunbar, et al., “Prediction and Prevention of TransplantRelated Mortality from Pulmonary Causes after Total Body Irradiation and Allogeneic Stem Cell Transplantation,” Biology of Blood and Marrow Transplantation, Vol. 11, No. 3, 2005, pp. 223-230. doi:10.1016/j.bbmt.2004.12.328
[9] B. N. Savani, A. Montero, R. Srinivasan, A. Singh, A. Shenoy, S. Mielke, et al., “Chronic GVHD and Pretransplantation Abnormalities in Pulmonary Function Are the Main Determinants Predicting Worsening Pulmonary Function in Long-Term Survivors after Stem Cell Transplantation,” Biology of Blood and Marrow Transplantation, Vol. 12, No. 12, 2006, pp. 1261-1269. doi:10.1016/j.bbmt.2006.07.016
[10] B. P. Soule, N. L. Simone, B. N. Savani, H. Ning, P. S. Albert, A. J. Barrett, et al., “Pulmonary Function Following Total Body Irradiation (with or without Lung Shielding) and Allogeneic Peripheral Blood Stem Cell Transplant,” Bone Marrow Transplant, Vol. 40, No. 6, 2007, pp. 573-578. doi:10.1038/sj.bmt.1705771
[11] K. Fujimaki, J. Taguchi, H. Fujita, M. Hattori, E. Yamazaki, N. Takahashi, et al., “Thiotepa/Cyclophosphamide/ TBI as a Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Myelodysplastic Syndrome,” Bone Marrow Transplant, Vol. 33, No. 8, 2004, pp. 789-792. doi:10.1038/sj.bmt.1704451
[12] A. H. Filipovich, D. Weisdorf, S. Pavletic, G. Socie, J. R. Wingard, S. J. Lee, et al., “National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. Diagnosis and Staging Working Group Report,” Biology of Blood and Marrow Transplantation, Vol. 11, No. 12, 2005, pp. 945-956. doi:10.1016/j.bbmt.2005.09.004
[13] D. Przepiorka, D. Weisdorf, P. Martin, H. G. Klingemann, P. Beatty, J. Hows, et al., “1994 Consensus Conference on Acute GVHD Grading,” Bone Marrow Transplant, Vol. 15, No. 6, 1995, pp. 825-828.
[14] H. M. Shulman, K. M. Sullivan, P. L. Weiden, G. B. McDonald, G. E. Striker, G. E. Sale, et al., “Chronic Graftversus-Host Syndrome in Man. A Long-Term Clinicopathologic Study of 20 Seattle Patients,” The American Journal of Medicine, Vol. 69, No. 2, 1980, pp. 204-217. doi:10.1016/0002-9343(80)90380-0
[15] J. W. Chien, D. K. Madtes and J. G. Clark, “Pulmonary Function Testing Prior to Hematopoietic Stem Cell Transplantation,” Bone Marrow Transplant, Vol. 35, No. 5, 2005, pp. 429-435. doi:10.1038/sj.bmt.1704783
[16] F. Patriarca, V. Poletti, U. Costabel, M. L. Battista, A. Sperotto, M. Medeot, et al., “Clinical Presentation, Outcome and Risk Factors of Late-Onset Non-Infectious Pulmonary Complications after Allogeneic Stem Cell Transplantation,” Current Stem Cell Research & Therapy, Vol. 4, No. 2, 2009, pp. 161-167. doi:10.2174/157488809788167436
[17] L. Bashoura, S. Gupta, A. Jain, D. R. Couriel, K. V. Komanduri, G. A. Eapen, et al., “Inhaled Corticosteroids Stabilize Constrictive Bronchiolitis after Hematopoietic Stem Cell Transplantation,” Bone Marrow Transplant, Vol. 41, No. 1, 2008, pp. 63-67. doi:10.1038/sj.bmt.1705877
[18] N. Maimon, J. H. Lipton, C. K. Chan and T. K. Marras, “Macrolides in the Treatment of Bronchiolitis Obliterans in Allograft Recipients,” Bone Marrow Transplant, Vol. 44, No. 2, 2009, pp. 69-73. doi:10.1038/bmt.2009.106
[19] R. Or, B. Gesundheit, I. Resnick, M. Bitan, A. Avraham, M. Avgil, et al., “Sparing Effect by Montelukast Treatment for Chronic Graft versus Host Disease: A Pilot Study,” Transplantation, Vol. 83, No. 5, 2007, pp. 577-581. doi:10.1097/01.tp.0000255575.03795.df

  
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