Diffusion capacity predicts long-term survival after allogeneic bone marrow transplantation for acute lymphoblastic leukemia.
BACKGROUND
The aim of this study was to evaluate changes in pulmonary function measures as predictors of outcome in acute lymphoblastic leukemia (ALL) patients after myeloablative allogeneic bone marrow transplantation (BMT).


METHODS
Forced expiratory volume in 1 second (FEV1) and diffusion capacity for carbon monoxide (DLCO) were evaluated before and after allogeneic BMT every 3 months in 32 patients who survived for at least 100 days. General case histories were also examined.


RESULTS
Univariate analysis revealed that decreased post-BMT DLCO was associated with increased overall and event-free survival (p < 0.05). While a pre-BMT FEV1 of < 70% was associated with significantly decreased overall survival (p < 0.05), multiple regression analysis indicated that patients without cytomegalovirus (CMV) infection, having limited chronic graft-versus-host disease (GVHD) and with markedly decreased DLCO had better overall survival (p < 0.05). After adjusting for age, gender, chronic GVHD, and CMV infection, patients with decreased DLCO exhibited enhanced overall survival. Two-year survival and event-free survival rates were significantly higher in patients with decreased DLCO.


CONCLUSIONS
We conclude that DLCO may be a good long-term predictor of outcome in patients with ALL following BMT.
Chang
Peter Mu-Hsin
PM
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chiou
Tzeon-Jye
TJ
Yen
Chueh-Chuan
CC
Hsiao
Liang-Tsai
LT
Liu
Jin-Hwang
JH
Chen
Po-Min
PM
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality*; D002248:Carbon Monoxide / Q000378:metabolism; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011653:Pulmonary Diffusing Capacity; D014184:Transplantation, Homologous
D002248:Carbon Monoxide