Abstract
We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58; score 1, n = 14; score 2, n = 6; score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.
Highlights
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative procedure for patients with hematologic malignancies
The goal of the present study was to perform a retrospective analysis of the relationship between pretransplantation lung function, posttransplantation lung function, and late-onset noninfectious pulmonary complications in adult patients surviving for ≥5 years after myeloablative HSCT
The present study demonstrated the clinical significance of pulmonary dysfunction in long-term survivors after myeloablative HSCT
Summary
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative procedure for patients with hematologic malignancies. Despite of improvements in supportive care, the morbidity and mortality associated with this procedure remains a major problem. Pulmonary complications occur in 40% to −60% of HSCT patients and account for 10% to 40% of transplant-related deaths [1]. Late-onset noninfectious pulmonary complications, such as bronchiolitis obliterans (BO), BO-organizing pneumonia and interstitial pneumonia occurring from 3 months after transplanttation are thought to be linked to chronic graft-versushost disease (GVHD) and can result in decreased quality of life or even death [2,3,4]. The goal of the present study was to perform a retrospective analysis of the relationship between pretransplantation lung function, posttransplantation lung function, and late-onset noninfectious pulmonary complications in adult patients surviving for ≥5 years after myeloablative HSCT
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