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Pulmonary function following allogeneic stem cell transplantation in childhood: A retrospective cohort study of 51 patients
Author(s) -
MadanatHarjuoja L. M.,
Valjento S.,
Vettenranta K.,
Kajosaari M.,
Dyba T.,
Taskinen M.
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12313
Subject(s) - medicine , pulmonary function testing , transplantation , proportional hazards model , cohort , retrospective cohort study , etiology , pediatrics
HSCT is associated with a high risk of late morbidity. The aim of this study was to evaluate the frequency, time frame, risk factors, and possible etiology of pulmonary dysfunction following allogeneic HSCT in childhood. We evaluated the pulmonary function of 51 HSCT patients (>6 yr), by including FVC and FEV 1 values prior to (baseline) and annually up to five yr after HSCT . A Cox proportional hazards model was used to analyze the risk factors for a pulmonary event. Over half (59%) of the patients developed pulmonary dysfunction, mainly consisting of restrictive abnormalities. Acute Gv HD ( HR 4.31, 95% CI 1.47–12.63), chronic Gv HD (HR 10.20, 95% CI 2.42–43.03), and an abnormal baseline pulmonary function ( HR 4.82, 95% CI 1.02–22.84) were associated with post‐transplant dysfunction. FEV 1 (p < 0.001) and FVC (p < 0.001) declined significantly by 12 months after HSCT and both remained below the pre‐ HSCT level at up to four yr post‐transplantation. HSCT in childhood is associated with early and persistent restrictive impairment of pulmonary function. Patients with extensive chronic Gv HD are particularly vulnerable to severe pulmonary dysfunction. Scheduled pulmonary function testing is warranted as part of the follow‐up of survivors of HSCT in childhood.