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Pretransplant lung function, respiratory failure, and mortality after stem cell transplantation
Tanyalak Parimon1, David K Madtes, David H Au
1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Summary
Pre-transplant lung function, specifically FEV(1) and DL(CO), predicts early respiratory failure and mortality risk after stem cell transplant. A higher lung function score indicates increased risk, aiding pre-transplant assessment.
Area of Science:
- Pulmonary Medicine
- Hematology
- Transplant Surgery
Background:
- The predictive value of pre-transplant pulmonary function for post-stem cell transplant respiratory complications remains debated.
- Early respiratory failure and mortality are significant concerns following stem cell transplantation.
Purpose of the Study:
- To investigate the association between pre-transplant lung function parameters and the risk of early respiratory failure and mortality.
- To develop a predictive score for pulmonary compromise before stem cell transplant.
Main Methods:
- Retrospective analysis of 2,852 stem cell transplant recipients (1990-2001).
- Assessment of pre-transplant pulmonary function tests including FEV(1), FVC, TLC, DL(CO), and P(A-a)O(2).
- Utilized Cox proportional hazard logistic models to evaluate associations with respiratory failure and mortality.
Main Results:
- Decreased lung function parameters correlated with increased risk of respiratory failure and mortality.
- A pre-transplant lung function score, based on FEV(1) and DL(CO), was developed.
- Higher lung function scores significantly increased the risk of early respiratory failure and death.
Conclusions:
- Compromised pre-transplant lung function is a significant risk factor for early respiratory failure and mortality.
- A pre-transplant lung function score using FEV(1) and DL(CO) can effectively estimate this risk.