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Related Experiment Videos

Long-term pulmonary function abnormalities and survival after allogeneic marrow transplantation.

T K Marras1, C K Chan, J H Lipton

  • 1Joint Division of Respirology, Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. ted.marras@utoronto.ca

Bone Marrow Transplantation
|January 13, 2004
PubMed
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Pulmonary function testing after allogeneic marrow transplant shows common diffusion impairment, decreasing obstruction, and stable restriction. Obstruction is linked to mortality and chronic graft-versus-host disease, while non-sibling donors increase restriction risk.

Area of Science:

  • Pulmonary Medicine
  • Hematology
  • Transplantation Immunology

Background:

  • Allogeneic bone marrow transplantation (BMT) can lead to long-term pulmonary complications.
  • Understanding the natural history and risk factors for these complications is crucial for patient management.

Purpose of the Study:

  • To evaluate long-term pulmonary function test (PFT) outcomes in survivors of allogeneic BMT.
  • To identify factors associated with pulmonary obstruction, restriction, and diffusion impairment.
  • To assess the impact of these impairments on mortality.

Main Methods:

  • Retrospective cohort study of 6-month survivors of allogeneic BMT (1980-1997).
  • Analysis of pulmonary function tests including FEV1/FVC, TLC, and diffusion capacity.

Related Experiment Videos

  • Statistical analysis to determine prevalence, trends, and associations with mortality and clinical factors.

    • Main Results:

    • Over 5 years, mean declines were observed in FEV1/FVC (4%), TLC (7%), and diffusion (17%), with TLC and diffusion tending to increase later.
    • Prevalence of abnormalities: 6% obstruction, 12% restriction, 35% diffusion impairment.
    • Obstruction decreased in frequency over time (5% vs 15%) and was associated with higher mortality (HR 2.0).
    • Chronic graft-versus-host disease (cGVHD) and busulfan were linked to obstruction; non-sibling/mismatched donors were linked to restriction.

    Conclusions:

    • Decreased diffusion capacity is common but generally benign after BMT.
    • Pulmonary obstruction, while decreasing in frequency, is associated with increased mortality and cGVHD.
    • Risk factors for restriction include using non-sibling or mismatched donors.