Longitudinal changes in pulmonary function following bone marrow transplantation
D S Prince1, J R Wingard, R Saral
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore.
Chest
|August 1, 1989
Summary
Bone marrow transplant recipients may experience declining lung function, specifically diffusing capacity, even without initial respiratory symptoms. Early detection of subclinical changes is crucial for preventing severe pulmonary complications like bronchiolitis obliterans.
Area of Science:
- Pulmonology
- Hematology
- Transplantation Medicine
Background:
- Bone marrow transplantation (BMT) is a life-saving procedure for various hematologic malignancies and other diseases.
- Pulmonary complications are a significant cause of morbidity and mortality post-BMT.
- Longitudinal changes in pulmonary function in asymptomatic BMT recipients require further investigation.
Purpose of the Study:
- To prospectively evaluate pulmonary function changes in asymptomatic patients following bone marrow transplantation.
- To identify factors influencing longitudinal pulmonary function decline after BMT.
- To assess the risk of developing subclinical pulmonary disease post-BMT.
Main Methods:
- Prospective follow-up of 34 asymptomatic bone marrow transplant recipients.
- Mean follow-up duration of two years.
- Pulmonary function tests including spirometry and lung volumes were performed.
Main Results:
- Lung volumes and spirometry were generally preserved.
- A significant annual decline of 11.9% in diffusing capacity was observed.
- Patients with chronic graft-versus-host disease (CGVHD) showed progressive obstructive ventilatory impairment.
- Patients transplanted for chronic myeloid leukemia (CML) exhibited a significant fall in diffusing capacity.
Conclusions:
- Asymptomatic BMT recipients can develop progressive pulmonary function decline, particularly in diffusing capacity.
- Subclinical pulmonary impairment, especially in patients with CGVHD, may precede serious conditions like bronchiolitis obliterans.
- Early monitoring of pulmonary function is essential for identifying at-risk patients post-BMT.
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