Repair of impaired pulmonary function is possible in very-long-term allogeneic stem cell transplantation survivors

Natasha A. Jain, Priyanka A. Pophali, Jeffrey K. Klotz, Sawa Ito, Eleftheria Koklanaris, Kamna Chawla, Christopher S. Hourigan, Nicole Gormley, Bipin N. Savani, Austin John Barrett, Minoo Battiwalla

Research output: Contribution to journalArticlepeer-review

Abstract

Both early- and late-onset noninfectious pulmonary injury are important contributors to the nonrelapse mortality seen after allogeneic stem cell transplantation (allo-SCT), particularly in subjects conditioned with high-dose total body irradiation (TBI). To characterize the kinetics of recovery from pulmonary injury in long-term survivors, we collected data on 138 subjects who survived > 3 years (median survival, 10.2 years) after predominantly TBI-based allo-SCT from their HLA-matched siblings. Baseline pulmonary function tests served as the reference for subsequent measurements at 3, 5, 10, and 15 years for each survivor. The only parameter showing a clinically and statistically significant decline post-transplant was adjusted diffusion capacity of lung for carbon monoxide (DLCO), which reached a nadir at 5 years but surprisingly normalized at the 10-year mark. Multivariable modeling identified chronic graft-versus-host disease (P < .02) and abnormal baseline-adjusted DLCO (P < .03) as the only significant factors associated with the decline in adjusted DLCO at 5 years but excluded smoking, conditioning intensity, baseline C-reactive protein level, TBI dose to the lungs, disease, and demographic variables. In conclusion, pulmonary injury as monitored by the adjusted DLCO continues to deteriorate in the first 5 years after allo-SCT but recovers at 10 years.

Original languageEnglish (US)
Pages (from-to)209-213
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number2
DOIs
StatePublished - Feb 2014
Externally publishedYes

Keywords

  • Adjusted DLCO
  • Allogeneic
  • BMT
  • DLCO
  • HSCT
  • Long-term survivor
  • Lung shielding
  • Pulmonary complications
  • Pulmonary function
  • Stem cell transplant
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint

Dive into the research topics of 'Repair of impaired pulmonary function is possible in very-long-term allogeneic stem cell transplantation survivors'. Together they form a unique fingerprint.

Cite this