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.

  • Letter to the Editor
  • Published:

Decreased pulmonary function in asymptomatic long-term survivors after allogeneic hematopoietic stem cell transplant

Bone Marrow Transplantation volume 51, pages 283–285 (2016)Cite this article

Subjects

Lung function after allogeneic hematopoietic stem cell transplant (HSCT) can be impaired by multiple factors including prior history of tobacco use, chemotherapy exposures, current or prior infections and chronic GvHD.1, 2

The alkylator busulfan (Bu), extensively utilized in conditioning regimens before HSCT,3, 4 can cause acute lung injury, chronic interstitial fibrosis and alveolar hemorrhage which can lead to decreases in lung function as measured by diffusion capacity for carbon monoxide (DLCO), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio and total lung capacity (TLC).5, 6, 7 Although pulmonary illness may lead to significant symptomatology, it is not known if asymptomatic patients have abnormal pulmonary function after HSCT.8 On the other hand, although routine pulmonary function testing (PFT) by spirometry is recommended following transplantation in order to identify early signs of lung GvHD,9, 10 few data exist to guide clinical decisions in those patients who do have a decrease in lung function in the absence of pulmonary symptoms.2, 11, 12, 13

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

References

  1. Sakaida E, Nakaseko C, Harima A, Yokota A, Cho R, Saito Y et al. Late-onset noninfectious pulmonary complications after allogeneic stem cell transplantation are significantly associated with chronic graft-versus-host disease and with the graft-versus-leukemia effect. Blood 2003; 102: 4236–4242.

    Article  CAS  PubMed  Google Scholar 

  2. Marras TK, Chan CK, Lipton JH, Messner HA, Szalai JP, Laupacis A . Long-term pulmonary function abnormalities and survival after allogeneic marrow transplantation. Bone Marrow Transplant 2004; 33: 509–517.

    Article  CAS  PubMed  Google Scholar 

  3. Beri R, Chunduri S, Sweiss K, Peace DJ, Mactal-Haaf C, Dobogai LC et al. Reliability of a pretransplant i.v. BU test dose performed 2 weeks before myeloablative FluBu conditioning regimen. Bone Marrow Transplant 2010; 45: 249–253.

    Article  CAS  PubMed  Google Scholar 

  4. Chunduri S, Dobogai LC, Peace D, Saunthararajah Y, Quigley J, Chen Y-H et al. Fludarabine/i.v. BU conditioning regimen: myeloablative, reduced intensity or both? Bone Marrow Transplant 2008; 41: 935–940.

    Article  CAS  PubMed  Google Scholar 

  5. Lund MB, Kongerud J, Brinch L, Evensen SA, Boe J . Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamide. Eur Respir J 1995; 8: 1269–1274.

    Article  CAS  PubMed  Google Scholar 

  6. Bruno B, Souillet G, Bertrand Y, Werck-Gallois MC, So Satta A, Bellon G . Effects of allogeneic bone marrow transplantation on pulmonary function in 80 children in a single paediatric centre. Bone Marrow Transplant 2004; 34: 143–147.

    Article  CAS  PubMed  Google Scholar 

  7. Ringden O, Remberger M, Ruutu T, Nikoskelainen J, Volin L, Vindeløv L et al. Increased risk of chronic graft-versus-host disease, obstructive bronchiolitis, and alopecia with busulfan versus total body irradiation: long-term results of a randomized trial in allogeneic marrow recipients with leukemia. Nordic Bone Marrow Transplantation Group. Blood 1999; 93: 2196–2201.

    CAS  PubMed  Google Scholar 

  8. Chiou TJ, Tung SL, Wang WS, Tzeng WF, Yen CC, Fan FS et al. Pulmonary function changes in long-term survivors of chronic myelogenous leukemia after allogeneic bone marrow transplantation: a Taiwan experience. Cancer Invest 2002; 20: 880–888.

    Article  PubMed  Google Scholar 

  9. Hildebrandt GC, Fazekas T, Lawitschka A, Bertz H, Greinix H, Halter J et al. Diagnosis and treatment of pulmonary chronic GVHD: report from the consensus conference on clinical practice in chronic GVHD. Bone Marrow Transplant 2011; 46: 1283–1295.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Williams KM, Chien JW, Gladwin MT, Pavletic SZ . Bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation. JAMA 2009; 302: 306–314.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Palmer J, Williams K, Inamoto Y, Chai X, Martin PJ, Tomas LS et al. Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease. Biol Blood Marrow Transplant 2014; 20: 337–344.

    Article  PubMed  Google Scholar 

  12. Bacigalupo A, Chien J, Barisione G, Pavletic S . Late pulmonary complications after allogeneic hematopoietic stem cell transplantation: diagnosis, monitoring, prevention, and treatment. Semin Hematol 2012; 49: 15–24.

    Article  PubMed  Google Scholar 

  13. Afessa B, Litzow MR, Tefferi A . Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplant 2001; 28: 425–434.

    Article  CAS  PubMed  Google Scholar 

  14. Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report. Biol Blood Marrow Transplant 2015; 21: 389–401.e1.

    Article  PubMed  Google Scholar 

  15. Carpenter P, Kitko C, Elad S, Flowers ME, Gea-Banacloche JC, Halter JP et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: V. The 2014 Ancillary Therapy and Supportive Care Working Group Report. Biol Blood Marrow Transplant 2015; 21: 1167–1187.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology/ Oncology, University of Illinois Hospital and Health Science System, Chicago, IL, USA

    A L Oh, P Patel, R Chowdhery & D Rondelli

  2. University of Illinois Cancer Center, Chicago, IL, USA

    P Patel & D Rondelli

  3. Department of Pharmacy Practice, University of Illinois Hospital and Health Science System, Chicago, IL, USA

    K Sweiss

  4. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Hospital and Health Science System, Chicago, IL, USA

    S Dudek

Authors
  1. A L Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K Sweiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R Chowdhery
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S Dudek
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D Rondelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Rondelli.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oh, A., Patel, P., Sweiss, K. et al. Decreased pulmonary function in asymptomatic long-term survivors after allogeneic hematopoietic stem cell transplant. Bone Marrow Transplant 51, 283–285 (2016). https://doi.org/10.1038/bmt.2015.216

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2015.216

This article is cited by

Search

Advanced search

Quick links