Repair of Impaired Pulmonary Function Is Possible in Very-Long-Term Allogeneic Stem Cell Transplantation Survivors
| Autor: | Natasha A. Jain, Nicole Gormley, Minoo Battiwalla, Jeffrey K. Klotz, Christopher S. Hourigan, Priyanka A. Pophali, Austin John Barrett, Bipin N. Savani, Sawa Ito, Kamna Chawla, Eleftheria Koklanaris |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Pulmonary function medicine.medical_treatment Hematopoietic stem cell transplantation Transplantation Autologous Article Pulmonary function testing DLCO Adjusted DLCO Internal medicine Total body irradiation medicine Lung shielding Humans Long-term survivor Survivors Lung Allogeneic Transplantation business.industry BMT Hematopoietic Stem Cell Transplantation Long Term Survivor Hematology Surgery Respiratory Function Tests medicine.anatomical_structure Cross-Sectional Studies HSCT Cardiology Female Stem cell transplant Pulmonary complications business |
| Zdroj: | Biology of Blood and Marrow Transplantation. (2):209-213 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2013.10.025 |
| Popis: | Both early- and late-onset noninfectious pulmonary injury are important contributors to the nonrelapse mortality seen after allogeneic stem cell transplantation (allo-SCT), particularly in subjects conditioned with high-dose total body irradiation (TBI). To characterize the kinetics of recovery from pulmonary injury in long-term survivors, we collected data on 138 subjects who survived > 3 years (median survival, 10.2 years) after predominantly TBI-based allo-SCT from their HLA-matched siblings. Baseline pulmonary function tests served as the reference for subsequent measurements at 3, 5, 10, and 15 years for each survivor. The only parameter showing a clinically and statistically significant decline post-transplant was adjusted diffusion capacity of lung for carbon monoxide (DLCO), which reached a nadir at 5 years but surprisingly normalized at the 10-year mark. Multivariable modeling identified chronic graft-versus-host disease (P < .02) and abnormal baseline-adjusted DLCO (P < .03) as the only significant factors associated with the decline in adjusted DLCO at 5 years but excluded smoking, conditioning intensity, baseline C-reactive protein level, TBI dose to the lungs, disease, and demographic variables. In conclusion, pulmonary injury as monitored by the adjusted DLCO continues to deteriorate in the first 5 years after allo-SCT but recovers at 10 years. |
| Databáze: | OpenAIRE |
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