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A retrospective multi-centre study of the effects of allogeneic haematopoietic SCT on pulmonary function

Bone Marrow Transplantation volume 49, pages 1442–1443 (2014)Cite this article

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Chronic pulmonary complications of haematopoietic SCTs (HSCTs) include interstitial disease and bronchiolitis obliterans (BO). BO almost exclusively occurs in allograft recipients (usually 12 months post HSCT1,2) and is closely associated with chronic GvHD and a poorer outcome post HSCT. Identified risk factors for BO include older age of recipient/donor, pre-transplant lung function abnormalities, female donor for male patients and low levels of IgG.1, 2, 3 The proportion of HSCT recipients developing lung GvHD varies from 1 to 40%1, 2, 3, 4 among studies. More accurate data are required for planning controlled trials of treatments such as azithromycin, which is an effective treatment for BO post lung transplantation.5,6 We have therefore performed a retrospective study to estimate the current UK prevalence of new lung function impairment following allogeneic HSCT to help plan future prospective studies of aetiological associations or therapies for lung GvHD.

We retrospectively reviewed the British Society of Blood and Marrow Transplantation database for patients ⩾18 years undergoing first-time allogeneic HSCT between 2004 and 2007. Six UK centres participated and only patients with pulmonary function tests (PFTs) obtained<3 months prior to HSCT were included. Demographic, diagnosis, transplant type, conditioning treatment and PFT data were collected. Post-HSCT data were obtained from PFT recorded between 12 month and 24 months post transplant. Impaired lung function was defined as forced expiratory volume for 1 s (FEV1) or forced vital capacity (FVC) <80% predicted. Lung function defects were defined as: obstructive FEV1/FVC ratio<70%; probable restrictive FEV1/FVC ratio >80% (lung volumes were not available); and mixed-pattern FEV1/FVC ratio 70–80%. Two-sided P-values were calculated using Stata 11 and 95% was used as the significance level.

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Acknowledgements

The authors would like to thank the BSBMT for sponsoring the study and the data managers and transplant physicians at the participating centres for providing the data: Dr A Peniket, Director of Bone Marrow Transplantation, Churchill Hospital, Oxford; Dr B Shaw, Institute of Cancer Research, Royal Marsden Hospital, London; Prof J Apperley, data manager F O’Boyle, Hammersmith Hospital, London; Dr T Littlewood, Oxford Radcliffe Hospitals, Oxford; Dr K Wilson, data manager S Nicholas, Cardiff University School of Medicine, Cardiff; Dr K Orchard, data manager C Hurlock, Southampton General Hospital, Southampton; Prof G Jackson, data manager L McNally, Freeman Road Hospital, Newcastle; Dr J Snowden, data manager A Sharma and B Holt, Sheffield Teaching Hospitals, Sheffield.

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Authors and Affiliations

  1. Department of Medicine, Centre for Inflammation and Tissue Repair, Royal Free and University College Medical School, Rayne Institute, London, UK

    R Dharmagunawardena, G Thomas & J S Brown

  2. British Society of Blood and Marrow Transplantation, BSBMT Data Registry, Guy’s Hospital, London, UK

    R M Pearce, K Kirkland & J Perry

  3. Centre for Haematology, Imperial College London at Hammersmith Hospital, London, UK

    J F Apperley

  4. Department of Haematology, Oxford Radcliffe Hospitals NHS Trust, Cancer and Haematology Centre, Churchill Hospital, Oxford, UK

    P Medd

  5. Institute of Cancer and Genetics, Cardiff University School of Medicine, Institute of Medical Genetics, Cardiff, UK

    K M O Wilson

  6. Department of Haematology, Southampton University Hospitals Trust, Southampton, UK

    K Orchard

  7. Department of Haematology, Freeman Road Hospital, Newcastle upon Tyne, UK

    G Jackson

  8. Department of Haematology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK

    J A Snowden

  9. Department of Haematology, St James’s Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

    G Cook

Authors
  1. R Dharmagunawardena
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  2. R M Pearce
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  3. G Thomas
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  4. K Kirkland
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  5. J Perry
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  6. J F Apperley
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  7. P Medd
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  8. K M O Wilson
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  9. K Orchard
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  10. G Jackson
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  11. J A Snowden
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  12. G Cook
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  13. J S Brown
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on behalf of the British Society of Blood and Marrow Transplantation, Clinical Trials Committee

Corresponding author

Correspondence to J S Brown.

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The authors declare no conflict of interest.

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Dharmagunawardena, R., Pearce, R., Thomas, G. et al. A retrospective multi-centre study of the effects of allogeneic haematopoietic SCT on pulmonary function. Bone Marrow Transplant 49, 1442–1443 (2014). https://doi.org/10.1038/bmt.2014.154

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