Effects of allogeneic bone marrow transplantation on pulmonary function in 80 children in a single paediatric centre

Area of Science:

• Pediatric Hematology/Oncology
• Pulmonary Medicine
• Transplantation Immunology

Background:

• Allogeneic bone marrow transplantation (BMT) is a curative therapy for various pediatric diseases.
• Pulmonary complications can significantly impact long-term outcomes post-BMT.
• Understanding factors influencing pulmonary function is crucial for improving patient care.

Purpose of the Study:

• To investigate the long-term pulmonary function test (PFT) results in children following allogeneic BMT.
• To identify associations between PFT abnormalities and conditioning regimens (TBI vs. busulphan) and graft-versus-host disease (GVHD).

Main Methods:

• Retrospective review of serial PFTs in 80 children undergoing allogeneic BMT over 16 years.
• Analysis of PFT data in relation to conditioning regimen and cytomegalovirus immune status.
• Comparison of lung function parameters between different conditioning groups and GVHD status.

Main Results:

• Significant declines in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were observed at 2 years post-BMT.
• Greater reductions in FEV1 and FEV1/FVC ratio were noted in patients conditioned with busulphan compared to total body irradiation (TBI).
• Patients with chronic GVHD exhibited significantly lower FEV1 and FEV1/FVC ratios, indicating airway obstruction.

Conclusions:

• Busulphan-based conditioning may be associated with increased long-term lung toxicity compared to TBI.
• Chronic GVHD is a significant risk factor for developing obstructive airway disease after BMT.
• These findings warrant consideration of conditioning regimen selection and GVHD management to mitigate pulmonary sequelae.