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Lung function after bone marrow grafting.

M H Depledge, A Barrett, R L Powles

    International Journal of Radiation Oncology, Biology, Physics
    |February 1, 1983
    PubMed
    Summary
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    Lung function in acute myeloid leukemia (AML) patients undergoing total body irradiation (TBI) and bone marrow transplantation (BMT) showed temporary decline post-procedure. Lung function improved after 100 days but did not fully recover pre-transplant levels.

    Area of Science:

    • Hematology
    • Pulmonology
    • Oncology

    Background:

    • Acute myeloid leukemia (AML) treatment often involves intensive regimens like total body irradiation (TBI) and bone marrow transplantation (BMT).
    • Pulmonary complications can significantly impact patient outcomes following TBI and BMT.

    Purpose of the Study:

    • To prospectively evaluate lung function changes in AML patients post-TBI and BMT.
    • To identify factors associated with pulmonary complications after transplantation.

    Main Methods:

    • Prospective lung function study of 48 AML patients treated with TBI and BMT.
    • Assessment of gas exchange, ventilatory defects, and diffusing capacity (DLCO) before and after transplantation.

    Main Results:

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  • Mildly impaired gas exchange was noted pre-transplant in some patients.
  • Progressive, subclinical lung function deterioration occurred within 100 days post-TBI/BMT.
  • Infection and graft-versus-host disease (GvHD) worsened lung function.
  • Ventilatory ability and gas transfer improved beyond 100 days but remained below pre-transplant levels.
  • No evidence of progressive pulmonary fibrosis was observed within the first year.

    • Conclusions:

    • TBI and BMT induce transient pulmonary changes in AML patients.
    • Pulmonary function recovery is incomplete, with GvHD and infection being significant complicating factors.
    • Long-term pulmonary fibrosis was not a major concern in this cohort within the first year.