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Post-Transplant Complications

Implications of early airflow decline after myeloablative allogeneic stem cell transplantation

Bone Marrow Transplantation volume 33, pages 759–764 (2004)Cite this article

Summary:

The clinical significance of early airflow decline after myeloablative allogeneic hematopoietic SCT is uncertain. We performed a retrospective cohort analysis to determine if airflow decline by day 100 is associated with later development of transplant-related airflow obstruction (AFO) and increased mortality risk. Overall, 750 (40%) patients had airflow decline by day 100. Development of airflow decline by day 100 was associated with an increased risk for AFO at 1 year (relative risk 2.6, 95% confidence interval 2.1–3.1) but not with an increase in mortality risk (hazard ratio (HR) 0.86, P=0.05). However, patients with the fastest rate of decline between day 100 and 1 year (12.5% per year ±24) had the highest mortality risk (HR 3.2, P<0.001). In conclusion, airflow measurements made on day 100 do not predict the rate of airflow decline between day 100 and 1 year, and therefore are not useful as a single measurement for determining mortality risk associated with development of AFO. Closer monitoring of the rate of airflow decline during the first year may facilitate the timely detection and treatment of early airflow decline and prevent the development of fixed AFO and increased mortality risk after hematopoietic stem cell transplant.

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Acknowledgements

Financial support for this study was received from NIH Grants T32 HL07287, PO1 CA 18029, HL36444, CA18221, 1R01 HL71914-01, 1K23HL69860-01, American Lung Association of Washington Research Grant.

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  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    J W Chien, P J Martin, M E Flowers, W G Nichols & J G Clark

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  1. J W Chien
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  2. P J Martin
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  3. M E Flowers
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Correspondence to J W Chien.

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Chien, J., Martin, P., Flowers, M. et al. Implications of early airflow decline after myeloablative allogeneic stem cell transplantation. Bone Marrow Transplant 33, 759–764 (2004). https://doi.org/10.1038/sj.bmt.1704422

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