Portal de Periódicos da CAPES

Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: Relationship to total body irradiation and graft-versus-host disease

1991; Elsevier BV; Volume: 20; Issue: 6 Linguagem: Inglês

10.1016/0360-3016(91)90231-r

1879-355X

Robert C. Tait, A.K. Burnett, A.G. Robertson, S.G. McNee, B.M.S. Al Riyami, Rosamund Carter, Robin Stevenson,

Transplantation: Methods and Outcomes

Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p < 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, as measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p < 0.01). Both were related, at least in part, to the presence of GVHD (p < 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p < 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients.