Subclinical disturbances in cardiac function at rest and in gas exchange during exercise are common findings after autologous bone marrow transplantation.
A study was undertaken to examine the effects of autologous bone marrow transplantation (BMT) on cardiac function at rest (n = 111) and pulmonary gas exchange during exercise (n = 110). Left ventricular cardiac ejection fraction (LVEF) was measured by radionuclide ventriculography before autologous BMT and after 6 months and 1, 3 and 5 years. Expired gas volume per oxygen consumption (VE/VO2) and transcutaneous PO2 were measured at rest and during submaximal exercise before and 6 and 12 months after autologous BMT, and the alveolar-arterial oxygen difference was calculated after 12 months. In lymphoma patients conditioned with BCNU, cyclophosphamide, etoposide and cytarabine, a long-lasting reduction in LVEF of 11 +/- 14% mean (+/- SD) was noted. The risk of cardiac deterioration was not increased by a subnormal LVEF before autologous BMT or total body irradiation (TBI). Impaired gas exchange during exercise was a common feature, but severe disturbances were uncommon. During exercise transcutaneous PO2 fell pathologically in 15% and 20% of the patients examined after 6 and 12 months, respectively, and the alveolar-arterial oxygen difference increased pathologically in 50% after 12 months. The VE/VO2 ratio increased significantly during exercise 6 months after autologous BMT in TBI-treated patients.
Carlson
K
K
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Smedmyr
B
B
Bäcklund
L
L
Simonsson
B
B
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D006321:Heart / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011659:Pulmonary Gas Exchange; D013997:Time Factors; D014182:Transplantation, Autologous