retrospectively assessed long-term pulmonary function in adults surviving for ≥5
years after myeloablative allogeneic hematopoietic stem cell
transplantation and identified risk factors for late-onset noninfectious
pulmonary complications. Among 174 patients
undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated.
Pulmonary function tests (PFTs) were performed before conditioning,
3 months and 1 year after transplantation, and then annually. Eight patients
(10%) had abnormal pulmonary function before transplantation, but this was not
associated with late changes in PFTs. Patients with chronic graft-versus-host
disease (GVHD) showed a significant decline of lung function after 3 years when
compared with patients without chronic GVHD. Abnormal pretransplantation lung
function was associated with pulmonary chronic GVHD according to National
Institutes of Health criteria (score 0, n=58; score 1, n=14; score 2, n=6; score 3, n=3). Five patients with late-onset noninfectious
pulmonary complications showed a decline of lung function at 1 year after
transplantation. Only chronic GVHD was significantly related to late-onset
noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be
associated with a decline in pulmonary function within 1 year after
transplantation, but late-onset noninfectious pulmonary complications could not
be predicted from pretransplantation lung function.
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