Late pulmonary impairment following allogeneic bone marrow transplantation.
The pulmonary function of 88 consecutive leukemic patients who had undergone allogeneic bone marrow transplantation (BMT) was studied beforehand, at 3 months, at 6 months, and annually thereafter until 5 years after grafting. The parameters for function which are indicative for obstructive and restrictive lung disease deteriorated in all patient groups during the first 3 to 6 months after BMT but partially recovered within one year. Long-term decline in lung function was similar in all patient groups, and neither the onset nor the magnitude of pulmonary dysfunction was related to the occurrence of pulmonary impairment within 6 months after grafting. Multivariate analysis was then employed to assess predictors for long-term pulmonary disease. Despite the obvious effect of chronic graft versus host disease on the course of lung function, it was in itself not a significant predictor of long-term pulmonary outcome. Rather, the conditioning regimen turned out to be indicative; compared with busulfan, fractionated total body irradiation was demonstrated to be clearly superior with a lower incidence of both restrictive and obstructive long-term lung impairment. Our data indicate a previously unknown long-term side effect of busulfan conditioning.
Beinert
T
T
Universitäts-Klinikum Charité, Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik II, Schumannstr. 20-21, Berlin D-10117, Germany.
Düll
T
T
Wolf
K
K
Holler
E
E
Vogelmeier
C
C
Behr
J
J
Kolb
H
H
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008171:Lung Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008173:Lung Diseases, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D012129:Respiratory Function Tests; D013997:Time Factors; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents