Pulmonary function changes 100 days and one year after bone marrow transplantation

The pulmonary function of patients receiving autologous or allogeneic bone marrow transplantation (BMT) was studied before, 100 days after and 1 year after BMT. The 117 patients studied before transplantation showed a slight reduction in average total lung capacity (TLC) and transfer coefficient (KCO). These reductions were related to haematological disease, previous pulmonary disease or irradiation, or use of toxic lung chemotherapy. Studies 100 days after BMT showed TLC and KCO decreases of 5% and 8%, respectively. These decreases were related to different factors in autologous and allogeneic BMT. The results were influenced by previous pulmonary status in autologous BMT patients and the occurrence of GVHD in allogeneic BMT patients. Seventy patients underwent pulmonary function testing 1 year after BMT. The decrease in TLC values was greater in autologous BMT than in allogeneic BMT patients (107 +/- 3% to 100 +/- 3% versus 113 +/- 3% to 112 +/- 2%, respectively) although TLC remained normal in both groups. KCO values dropped significantly in both populations. Relapse of the initial disease was an important factor impairing lung function in the autologous group. TLC and KCO changes were strongly related to mortality in both groups. These results emphasise the need for frequent pulmonary function tests after BMT to detect and quantify lung function changes.