title: Clinical impact of pre-transplant pulmonary impairment on survival after allogeneic hematopoietic stem cell transplantation.
abstract: We retrospectively analyzed the clinical outcomes of patients with pulmonary impairment before undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for the first time. Among 297 evaluable patients who underwent their first HSCT, 23 had restrictive, obstructive or mixed ventilatory impairment (n = 9, 13 and 1, respectively). Males predominated among the patients with pulmonary impairment (p = 0.037) and received a reduced intensity conditioning (RIC) regimen more frequently, although the difference did not reach statistical significance (p = 0.05). Among 23 patients with pulmonary impairment, 9 underwent post-transplant pulmonary function tests and obstructive ventilatory impairment progressed only in 2 patients, both of whom developed bronchiolitis obliterans. Kaplan-Meier estimates of 3-year overall (OS) among patients with and without pulmonary impairment were 57% and 47%, respectively, and those of relapse-free survival (RFS) were 70%, and 68%, respectively, with no significant differences between the groups (OS, p = 0.235; RFS, p = 0.287). The rates of non-relapse mortality also did not significantly differ (p = 0.835). Our results suggest that allogeneic HSCT is safe for patients with pulmonary impairment. The lower frequency of fatal pulmonary complications after HSCT and the RIC regimen might contribute to favorable survival rates.
authors: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Honkomagome, Bunkyo-ku, Japan. kakihana@cick.jp
authors: Kazuhiko
authors: K
authors: Kakihana
authors: Kazuteru
authors: K
authors: Ohashi
authors: Yuka
authors: Y
authors: Hirashima
authors: Yutaka
authors: Y
authors: Murata
authors: Takeshi
authors: T
authors: Kobayashi
authors: Takuya
authors: T
authors: Yamashita
authors: Hisashi
authors: H
authors: Sakamaki
authors: Hideki
authors: H
authors: Akiyama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001989:Bronchiolitis Obliterans / Q000503:physiopathology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008173:Lung Diseases, Obstructive / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome