Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation

Abstract

We performed a retrospective analysis of muscle strength testing obtained following sibling or unrelated donor hematopoietic stem cell transplant (HSCT) between 1 January 1999 and 31 December 2003 in a cohort of 44 subjects at Tufts-New England Medical Center. Maximal inspiratory pressure (PI(max)) was <or=80% predicted in 52% of subjects and <or=60% predicted in 20% of subjects; maximal expiratory pressure (PE(max)) was <or=80% predicted in 88% of subjects and <or=60% predicted in 74% of subjects. Patients with a PI(max) <or=60% predicted spent significantly longer time in hospital following HSCT compared with subjects with PI(max) 60% predicted. Grip strength (n=32) was reduced to <or=80% predicted in 75% of subjects and <or=60% predicted in 47% of subjects following HSCT. Analysis of paired measurements obtained before and after HSCT in 20 of the 44 subjects (45%) showed significant reduction in both PI(max) and PE(max) between the two measures. Respiratory and skeletal muscle weakness is present in a significant percentage of subjects undergoing pulmonary function testing in the post-HSCT period, and may contribute to pulmonary morbidity in subjects with pulmonary complications of HSCT.