Related Experiment Videos
Pulmonary function changes in long-term survivors of bone marrow transplantation
E M Gore1, C A Lawton, R C Ash
1Medical College of Wisconsin Affiliated Hospitals, Department of Radiation Oncology, Milwaukee 53226, USA.
Summary
Pulmonary function tests (PFTs) in bone marrow transplant (BMT) patients initially declined but recovered, with graft-versus-host disease (GVHD) and lung radiation dose impacting recovery.
Area of Science:
- Pulmonary Medicine
- Hematology
- Oncology
Background:
- Bone marrow transplantation (BMT) is a critical treatment for various hematologic malignancies and other diseases.
- Pulmonary complications can significantly impact patient outcomes following BMT.
Purpose of the Study:
- To evaluate long-term pulmonary function changes after BMT.
- To assess the clinical significance of these pulmonary function changes.
- To identify factors influencing pulmonary function post-BMT.
Main Methods:
- Pulmonary function tests (PFTs) were conducted on 111 adult BMT patients before and after transplantation (1985-1991).
- Key PFT parameters included FEV1, FVC, DLCO, and TLC.
- Factors analyzed included graft-versus-host disease (GVHD), total body irradiation (TBI) dose, lung radiation dose, and posttransplant pulmonary infections.
Main Results:
- Post-BMT, FEV1, FVC, and TLC showed an initial decline with subsequent recovery; DLCO remained significantly lower.
- Patients without acute or chronic GVHD and posttransplant pulmonary infection experienced earlier FEV1 recovery.
- Higher lung radiation dose correlated with decreased FVC at 2 years; no progressive obstructive pulmonary disease was observed.
Conclusions:
- Pulmonary function initially declines post-BMT but generally recovers over time.
- Graft-versus-host disease, posttransplant pulmonary infection, and higher lung radiation doses were associated with delayed or incomplete recovery.
- The BMT conditioning regimen, including TBI with pulmonary shielding, was well-tolerated by lungs in long-term survivors.