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Diffusing capacity impairment is prevalent in long-term lymphoma survivors after high-dose therapy with autologous stem cell transplantation

Bone Marrow Transplantation volume 52, pages 646–649 (2017)Cite this article

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With improvements in diagnosis and treatment,1 the number of lymphoma survivors (LSs) after high-dose therapy with autologous stem cell transplantation (HDT-ASCT) has increased.2, 3 Many LSs receiving HDT-ASCT have failed first-line chemo-/radiotherapy (RT), and may hence reach high cumulative doses of bleomycin, cyclophosphamide and chest RT, which are recognized risk factors for pulmonary toxicity among LSs.4, 5 Diffusing capacity impairment and how it relates to treatment and smoking among LSs after HDT-ASCT has only been addressed after short- or medium-term follow-up previously.6 Here, we present long-term diffusing capacity data in adult LSs after an average follow-up of 10.4 years post HDT-ASCT. We assessed the prevalence of impairment, compared diffusing capacity with normative reference data, and examined the influence of chest RT, chemotherapy, smoking, anemia, heart failure and sex.

The study population was recruited from a national cohort of all adult Hodgkin lymphoma (HL) and non-Hodgkin lymphoma survivors treated with HDT-ASCT in Norway between 1987 and 2008.7, 8 A total of 399 LSs aged ⩾18 years at treatment, resident in Norway by March 2012 and not currently undergoing active treatment for relapsed disease were considered eligible and invited to a follow-up examination. Participants for the present study on pulmonary function were recruited from Oslo (n=186) and St Olavs (n=40) University Hospitals. Between March 2012 and March 2014, the participants attended an outpatient visit undergoing thorough medical exams including pulmonary function tests, echocardiography, blood sampling and comorbidities registered by a physician. Treatment data were collected from medical records and hospital databases, and smoking data were recorded by questionnaire. For complete Methods, see Supplementary Material Online.

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Acknowledgements

We thank Unn-Merete Fagerli, MD PhD, for her contribution in patient recruitment and clinical assessment at St Olavs University Hospital. We thank Ronnie Babigumira, MSc, and Linda Vos, PhD, at the Cancer Registry of Norway for advice on data management and statistics. The study was supported by South-Eastern Norway Regional Health Authority, and received no funding from the medical industry. HH is in part supported by a grant from the Norwegian Cancer Society.

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Author notes

  1. C E Kiserud and M B Lund: Co-senior authors

Authors and Affiliations

  1. Department of Oncology, National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway

    J S Stenehjem, K B Smeland, S Kvaløy & C E Kiserud

  2. Department of Research, Cancer Registry of Norway, Oslo, Norway

    J S Stenehjem

  3. Department of Cardiology, Oslo University Hospital, Oslo, Norway

    K Murbraech

  4. Department of Oncology, Oslo University Hospital, Oslo, Norway

    H Holte

  5. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

    S Kvaløy & M B Lund

  6. Department of Cardiology, St Olavs University Hospital, Trondheim, Norway

    T Wethal

  7. Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway

    M B Lund

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  1. J S Stenehjem
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Correspondence to J S Stenehjem.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Stenehjem, J., Smeland, K., Murbraech, K. et al. Diffusing capacity impairment is prevalent in long-term lymphoma survivors after high-dose therapy with autologous stem cell transplantation. Bone Marrow Transplant 52, 646–649 (2017). https://doi.org/10.1038/bmt.2016.338

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