| Autor: |
Matute-Bello, G., McDonald, G.D., Hinds, M.S., Schoch, H.G., Crawford, S.W. |
| Předmět: |
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| Zdroj: |
Bone Marrow Transplantation; 6/1/98, Vol. 21 Issue 11, p1125, 6p |
| Abstrakt: |
We investigated an association between pulmonary function testing (PFT) before bone marrow transplantation and the development of severe veno-occlusive disease (VOD) of the liver. We previously noted that reductions in diffusing capacity of the lung for carbon monoxide (corrected for hemoglobin) (D[subL]CO[subC]) were associated with mortality after transplantation, but this was not caused by respiratory failure. We performed a case-series review of prospectively collected data from 307 marrow recipients who underwent PFT within 2 weeks of transplantation. Of these, 170 (56 %) developed VOD; 39 (13%) mild, 81 (26%) moderate, and 50 (16%) severe or fatal. Both total lung capacity (TLC) and DECO,. were associated with severe VOD in univariate analysis (P = 0.006 for each). However, D[subL]CO[subC] entered logistic regression models that contained variables for all known risk factors for severe VOD, while TLC did not contribute additional predictive information. The odds ratio (OR) associated with a DECO,. below the lower limits of normal (70% of predicted) was 2.4 (95% CI, 1.0 to 5.4; P = 0.04). We conclude that reduced diffusion capacity of the lung measured before marrow transplantation is an independent risk for severe hepatic VOD. We speculate that the decreased D[subL]CO[subC] indicates pre-existing systemic endothelial cell damage and a susceptibility to severe hepatic injury from chemotherapy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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