title: A longitudinal study of pulmonary function after stem cell transplantation, from childhood to young adulthood.
abstract: BACKGROUND
  Impairment of pulmonary function after stem cell transplantation (SCT) in childhood has been reported before. However, long-term longitudinal studies are scarce.
  
  
  METHODS
  We measured lung volumes and performed dynamic spirometry serially in 18 patients after SCT. At the last investigation, a median of 18.2 years after SCT, the patients were compared with 18 matched controls. The diffusing capacity (DLCO) was only compared cross-sectionally.
  
  
  RESULTS
  There was a significant increase in the prevalence of restrictive lung disease (RLD, total lung capacity <80% of that predicted) from 7% (1/14) before SCT to 28% (5/18) 5 years after SCT, and 61% (11/18) a median of 18.2 years after SCT (P = 0.002). In comparison, none of the controls had RLD (61% vs. 0%, P = 0.001). Before SCT, no patient had obstructive lung disease (OLD, forced expiratory volume in 1 sec/vital capacity <70). OLD was found in one of 18 patients (6%) 5 years after SCT but in none of the patients a median of 18.2 years after SCT. Three of the controls had OLD (P = 0.25). Eleven patients had diffusion impairment (DLCO <80% of that predicted), as opposed to none of the controls (P = 0.001). The DLCO corrected for alveolar volume was decreased in only two patients.
  
  
  CONCLUSIONS
  We documented an increase in the prevalence of RLD, but not of OLD, after SCT. At the last investigation, only two patients had diffusion impairment after correction for alveolar volume.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. per.frisk@kbh.uu.se
authors.forename: Per
authors.initials: P
authors.lastname: Frisk
authors.forename: Johan
authors.initials: J
authors.lastname: Arvidson
authors.forename: Hans
authors.initials: H
authors.lastname: Hedenström
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D014109:Total Lung Capacity