[The Significance of Pulmonary Function Testing Before and After Allogeneic Stem Cell Transplantation]

Area of Science:

• Hematology
• Pulmonology
• Transplant Medicine

Background:

• Allogeneic hematopoietic stem cell transplantation (allo-HCT) offers curative potential for hematological diseases but is associated with significant transplant-related mortality (TRM), nearly 25% of patients.
• TRM is primarily attributed to infections, graft-versus-host disease (GVHD), and organ dysfunction (liver, lung, kidney).
• Pulmonary complications, both infectious and noninfectious, are significant contributors to TRM post-allo-HCT.

Purpose of the Study:

• To highlight the critical role of pre- and post-transplant pulmonary function tests (PFTs) in managing patients undergoing allo-HCT.
• To emphasize PFTs' utility in predicting noninfectious pulmonary complications, specifically chronic GVHD of the lung (bronchiolitis obliterans syndrome - BOS).
• To underscore the necessity of PFTs for diagnosing BOS and assessing its severity, as well as predicting overall transplant outcomes.

Main Methods:

• This review synthesizes existing literature on the application and significance of PFTs in the context of allo-HCT.
• It examines how PFT parameters are integral to the diagnostic criteria and severity evaluation of BOS.
• The review discusses the predictive value of PFTs for TRM and overall transplant success.

Main Results:

• PFTs are essential for identifying patients at risk of developing pulmonary complications, including BOS.
• Diagnostic criteria and severity grading for BOS rely heavily on specific PFT parameters.
• Pre- and post-transplant PFTs serve as important predictors of TRM and overall survival after allo-HCT.

Conclusions:

• Pulmonary function tests are indispensable tools in the management of allo-HCT.
• Accurate diagnosis and severity assessment of BOS require PFT data.
• Further research and integration of PFTs are needed to optimize outcomes and reduce TRM in allo-HCT recipients.