Cardiac and respiratory function after bone marrow transplantation in children with leukaemia

Late cardiac and respiratory function changes were evaluated in children surviving disease-free more than 2 years after bone marrow transplantation (BMT) performed for haematological malignancies. Forty-one children received allogeneic and 10 autologous BMT. In all cases studied shortening fraction (SF) was always within normal limits from before BMT up to 4 years after BMT. SF, though still normal, was slightly lower in the group with higher pre-BMT cumulative anthracycline dose. Twenty-eight children underwent respiratory function tests regularly at all scheduled times (pre-BMT, +6 months, +1, +2, +3, +4 years after BMT). Vital capacity and total lung capacity showed a slight continuous decrease which was significant at 4 years after BMT (P = 0.015 and P = 0.003 respectively). The decline of forced expiratory volume in 1 s observed 1 year after BMT (P = 0.002) was roughly maintained over time. However, no children complained of symptoms attributable to respiratory dysfunction, and all indices studied were always within normal limits in almost all patients. So far late cardiac and lung changes following BMT in children seem to be negligible. However, whether such abnormalities could further worsen and impair adult quality of life remains to be ascertained.