title: Diffusion capacity predicts long-term survival after allogeneic bone marrow transplantation for acute lymphoblastic leukemia.
abstract: 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.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Peter Mu-Hsin
authors.initials: PM
authors.lastname: Chang
authors.forename: Tzeon-Jye
authors.initials: TJ
authors.lastname: Chiou
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
authors.forename: Liang-Tsai
authors.initials: LT
authors.lastname: Hsiao
authors.forename: Jin-Hwang
authors.initials: JH
authors.lastname: Liu
authors.forename: Po-Min
authors.initials: PM
authors.lastname: Chen
mesh_terms: 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
chemical_list: D002248:Carbon Monoxide