Lung function 5 yrs after allogeneic bone marrow transplantation conditioned with busulphan and cyclophosphamide

Area of Science:

• Hematology
• Pulmonology
• Transplantation Medicine

Background:

• Long-term lung function data post-bone marrow transplantation (BMT) remain inconclusive.
• Previous studies indicated a persistent reduction in gas transfer one year after allogeneic BMT using busulfan and cyclophosphamide conditioning.
• This study aimed to determine if the observed gas transfer reduction is permanent, transient, or progressive.

Purpose of the Study:

• To prospectively evaluate lung function changes up to five years after allogeneic BMT.
• To identify factors associated with lung function decline after BMT.
• To clarify the long-term trajectory of lung function following BMT with busulfan and cyclophosphamide conditioning.

Main Methods:

• Prospective study of 43 adult patients with malignant blood disorders undergoing BMT.
• Lung function measurements were taken pre-BMT, at 3-month intervals during the first year, and at 5 years post-BMT.
• Statistical analysis identified associations between clinical factors and lung function changes.

Main Results:

• A transient decline in lung volumes and a persistent reduction in gas transfer were observed within the first year post-BMT.
• Lung function generally restored to baseline levels by 5 years, except in four patients who developed obliterative bronchiolitis.
• Acute leukemia and smoking were independently associated with reduced gas transfer at baseline and during the first year.

Conclusions:

• Allogeneic BMT with busulfan and cyclophosphamide conditioning can cause a temporary reduction in gas transfer, usually resolving by 5 years.
• Recovery of lung function can be slow, necessitating observation periods exceeding one year.
• Obliterative bronchiolitis is a potential long-term complication in a subset of patients post-BMT.