Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease

Tait, R.C. , Burnett, A.K., Robertson, A.G., McNee, S., Riyami, B.M.S., Carter, R. and Stevenson, R.D. (1991) Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease. International Journal of Radiation Oncology, Biology, Physics, 20(6), pp. 1219-1227. (doi: 10.1016/0360-3016(91)90231-R) (PMID:2045296)

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Abstract

Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p < 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, as measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p < 0.01). Both were related, at least in part, to the presence of GVHD (p < 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p < 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Tait, Dr Robert
Authors: Tait, R.C., Burnett, A.K., Robertson, A.G., McNee, S., Riyami, B.M.S., Carter, R., and Stevenson, R.D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:International Journal of Radiation Oncology, Biology, Physics
Publisher:Pergamon Press
ISSN:0360-3016
ISSN (Online):1879-355X

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