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Lung function abnormalities after bone marrow transplantation in children: has the trend recently changed?
I Cerveri1, P Fulgoni, G Giorgiani
1Clinic of Respiratory Diseases, Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico "San Matteo", Pavia, Italy. isa@mbox.systemy.it
Chest
|December 18, 2001
Summary
Children undergoing bone marrow transplantation (BMT) for leukemia frequently develop early and late lung function abnormalities. Advanced disease phase and infections predict these pulmonary issues, which appear more severe than in the 1980s.
Area of Science:
- Pediatric Pulmonology
- Hematology/Oncology
- Transplantation Medicine
Background:
- Bone marrow transplantation (BMT) is a critical treatment for pediatric leukemias.
- Pulmonary complications are a significant concern following BMT.
- Understanding lung function changes is vital for long-term patient outcomes.
Purpose of the Study:
- To assess early and late lung function abnormalities in children post-BMT for leukemia.
- To identify predictors of pulmonary dysfunction after BMT.
- To compare findings with historical data from the 1980s.
Main Methods:
- Prospective cohort study of 75 children undergoing BMT for leukemia.
- Lung function tests and clinical exams performed pre-BMT and at 3-6, 12, and 24 months post-BMT.
- Analysis of autologous and allogeneic BMT recipients.
Main Results:
- High prevalence of altered lung function: 44% pre-BMT, 85% at 3-6 months, 62% at 24 months.
- Restrictive lung pattern most common between 3-6 months post-BMT.
- Predictors for late abnormalities included advanced disease phase (OR 6.75) and bronchopulmonary infections (OR 3.9).
Conclusions:
- A substantial number of children experience early and late pulmonary abnormalities after BMT for leukemia.
- Late pulmonary abnormalities appear more severe compared to the 1980s cohort.
- Intensified front-line leukemia treatments in the 1990s may contribute to increased pulmonary severity.