Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Complications

Pulmonary function after autologous bone marrow transplantation in children: a long-term prospective study

Bone Marrow Transplantation volume 33, pages 645–650 (2004)Cite this article

Summary:

We performed serial pulmonary function tests (PFTs) consisting of spirometry and diffusing capacity in 26 children after BMT. The median follow-up was 10 years. The influence of total body irradiation (TBI) on long-term pulmonary function was of particular interest. In the 20 children who had received TBI, after an initial decrease the PFTs showed recovery, but the mean lung volumes were still significantly decreased 5 years after BMT at 10% below baseline. The proportions of children with restrictive impairment 5 and 10 years after BMT were 20 and 21%, respectively. Only one child was diagnosed with obstructive impairment. The proportions of children with isolated diffusing impairment at 5 and 10 years were 7/20 (35%) and 7/13 (54%), respectively. Six children had received chemotherapy only and showed isolated diffusing impairment as the only long-term sequela in 4/5 and 1/3 at 5 and 10 years. Our main finding was that there was little change in PFTs 1–10 years after BMT. TBI was associated with persistently decreased lung volumes in a proportion of patients, whereas chemotherapy also might have been of importance for the development of impaired gas exchange.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Soubani AO, Miller KB, Hassoun PM . Pulmonary complications of bone marrow transplantation. Chest 1996; 109: 1066–1077.

    CAS  Google Scholar 

  2. Palmas A, Tefferi A, Myers JL et al. Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation. Br J Haematol 1998; 100: 680–687.

    CAS  Google Scholar 

  3. Nysom K, Holm K, Hesse B et al. Lung function after allogeneic bone marrow transplantation for leukaemia or lymphoma. Arch Dis Child 1996; 74: 432–436.

    CAS  PubMed Central  Google Scholar 

  4. Kaplan EB, Wodell RA, Wilmott RW et al. Late effects of bone marrow transplantation on pulmonary function in children. Bone Marrow Transplant 1994; 14: 613–621.

    CAS  Google Scholar 

  5. Rovelli A, Pezzini C, Silvestri D et al. Cardiac and respiratory function after bone marrow transplantation in children with leukaemia. Bone Marrow Transplant 1995; 16: 571–576.

    CAS  Google Scholar 

  6. Fanfulla F, Locatelli F, Zoia MC et al. Pulmonary complications and respiratory function changes after bone marrow transplantation in children. Eur Respir J 1997; 10: 2301–2306.

    CAS  Google Scholar 

  7. Cerveri I, Fulgoni P, Giorgiani G et al. Lung function abnormalities after bone marrow transplantation in children: has the trend recently changed? Chest 2001; 120: 1900–1906.

    CAS  Google Scholar 

  8. Duncker C, Dohr D, Harsdorf S et al. Non-infectious lung complications are closely associated with chronic graft-versus-host disease: a single center study of incidence, risk factors and outcome. Bone Marrow Transplant 2000; 25: 1263–1268.

    CAS  Google Scholar 

  9. Arvidson J, Bratteby LE, Carlson K et al. Pulmonary function after autologous bone marrow transplantation in children. Bone Marrow Transplant 1994; 14: 117–123.

    CAS  Google Scholar 

  10. Gustafsson G, Kreuger A, Clausen N et al. Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO). Acta Paediatr 1998; 87: 1151–1161.

    CAS  Google Scholar 

  11. Lie SO, Jonmundsson G, Mellander L et al. A population-based study of 272 children with acute myeloid leukaemia treated on two consecutive protocols with different intensity: best outcome in girls, infants, and children with Down's syndrome. Nordic Society of Paediatric Haematology and Oncology (NOPHO). Br J Haematol 1996; 94: 82–88.

    CAS  Google Scholar 

  12. Lonnerholm G, Simonsson B, Arvidson J et al. Autologous bone marrow transplantation in children with acute lymphoblastic leukemia. Acta Paediatr 1992; 81: 1017–1022.

    CAS  Google Scholar 

  13. Solymar L, Aronsson PH, Bake B et al. Nitrogen single breath test, flow–volume curves and spirometry in healthy children, 7–18 years of age. Eur J Respir Dis 1980; 61: 275–286.

    CAS  Google Scholar 

  14. Hedenstrom H, Malmberg P, Agarwal K . Reference values for lung function tests in females. Regression equations with smoking variables. Bull Eur Physiopathol Respir 1985; 21: 551–557.

    CAS  Google Scholar 

  15. Hedenstrom H, Malmberg P, Fridriksson HV . Reference values for lung function tests in men: regression equations with smoking variables. Ups J Med Sci 1986; 91: 299–310.

    CAS  Google Scholar 

  16. Nysom K, Ulrik CS, Hesse B et al. Published models and local data can bridge the gap between reference values of lung function for children and adults. Eur Respir J 1997; 10: 1591–1598.

    CAS  Google Scholar 

  17. Clark JG, Hansen JA, Hertz MI et al. NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am Rev Respir Dis 1993; 147: 1601–1606.

    CAS  Google Scholar 

  18. Karlberg P, Taranger J, Engstrom I et al. I. Physical growth from birth to 16 years and longitudinal outcome of the study during the same age period. Acta Paediatr Scand Suppl 1976; 258: 7–76.

    Google Scholar 

  19. Gerver WJ, De Bruin R . Relationship between height, sitting height and subischial leg length in Dutch children: presentation of normal values. Acta Paediatr 1995; 84: 532–535.

    CAS  Google Scholar 

  20. Carlson K, Backlund L, Smedmyr B et al. Pulmonary function and complications subsequent to autologous bone marrow transplantation. Bone Marrow Transplant 1994; 14: 805–811.

    CAS  Google Scholar 

  21. Tait RC, Burnett AK, Robertson AG et al. Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease. Int J Radiat Oncol Biol Phys 1991; 20: 1219–1227.

    CAS  Google Scholar 

  22. Quigley PM, Yeager AM, Loughlin GM . The effects of bone marrow transplantation on pulmonary function in children. Pediatr Pulmonol 1994; 18: 361–367.

    CAS  Google Scholar 

  23. Schultz KR, Green GJ, Wensley D et al. Obstructive lung disease in children after allogeneic bone marrow transplantation. Blood 1994; 84: 3212–3220.

    CAS  Google Scholar 

  24. Seiden MV, Elias A, Ayash L et al. Pulmonary toxicity associated with high dose chemotherapy in the treatment of solid tumors with autologous marrow transplant: an analysis of four chemotherapy regimens. Bone Marrow Transplant 1992; 10: 57–63.

    CAS  Google Scholar 

  25. Abid SH, Malhotra V, Perry MC . Radiation-induced and chemotherapy-induced pulmonary injury. Curr Opin Oncol 2001; 13: 242–248.

    CAS  Google Scholar 

  26. Lonnerholm G, Arvidson J, Andersson LG et al. Myocardial function after autologous bone marrow transplantation in children: a prospective long-term study. Acta Paediatr 1999; 88: 186–192.

    CAS  Google Scholar 

  27. Thomas BC, Stanhope R, Plowman PN et al. Growth following single fraction and fractionated total body irradiation for bone marrow transplantation. Eur J Pediatr 1993; 152: 888–892.

    CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by the Children's Cancer Foundation in Sweden.

Author information

Authors and Affiliations

  1. Department of Women's and Children's Health, University Hospital, Uppsala, Sweden

    P Frisk, J Arvidson & G Lönnerholm

  2. Department of Clinical Physiology, University Hospital, Uppsala, Sweden

    L-E Bratteby & H Hedenström

Authors
  1. P Frisk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Arvidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L-E Bratteby
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Hedenström
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G Lönnerholm
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P Frisk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frisk, P., Arvidson, J., Bratteby, LE. et al. Pulmonary function after autologous bone marrow transplantation in children: a long-term prospective study. Bone Marrow Transplant 33, 645–650 (2004). https://doi.org/10.1038/sj.bmt.1704393

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704393

Keywords

This article is cited by

Search

Advanced search

Quick links