Skip to main content

Advertisement

SpringerLink
Log in

Clinical Impact of Pre-transplant Pulmonary Impairment on Survival After Allogeneic Hematopoietic Stem Cell Transplantation

  • Research
  • Published:
Pathology & Oncology Research

Abstract

We retrospectively analyzed the clinical outcomes of patients with pulmonary impairment before undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for the first time. Among 297 evaluable patients who underwent their first HSCT, 23 had restrictive, obstructive or mixed ventilatory impairment (n = 9, 13 and 1, respectively). Males predominated among the patients with pulmonary impairment (p = 0.037) and received a reduced intensity conditioning (RIC) regimen more frequently, although the difference did not reach statistical significance (p = 0.05). Among 23 patients with pulmonary impairment, 9 underwent post-transplant pulmonary function tests and obstructive ventilatory impairment progressed only in 2 patients, both of whom developed bronchiolitis obliterans. Kaplan-Meier estimates of 3-year overall (OS) among patients with and without pulmonary impairment were 57% and 47%, respectively, and those of relapse-free survival (RFS) were 70%, and 68%, respectively, with no significant differences between the groups (OS, p = 0.235; RFS, p = 0.287). The rates of non-relapse mortality also did not significantly differ (p = 0.835). Our results suggest that allogeneic HSCT is safe for patients with pulmonary impairment. The lower frequency of fatal pulmonary complications after HSCT and the RIC regimen might contribute to favorable survival rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Marras TK, Szalai JP, Chan CK, Lipton JH, Messner HA, Laupacis A (2002) Pulmonary function abnormalities after allogeneic marrow transplantation: a systematic review and assessment of an existing predictive instrument. Bone Marrow Transplant 30:599–607

    Article  PubMed  CAS  Google Scholar 

  2. Badier M, Guillot C, Delpierre S, Vanuxem P, Blaise D, Maraninchi D (1993) Pulmonary function changes 100 days and one year after bone marrow transplantation. Bone Marrow Transplant 12:457–461

    PubMed  CAS  Google Scholar 

  3. Gore EM, Lawton CA, Ash RC, Lipchik RJ (1996) Pulmonary function changes in long-term survivors of bone marrow transplantation. Int J Radiat Oncol Biol Phys 36:67–75

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  5. Clark JG, Schwartz DA, Flournoy N, Sullivan KM, Crawford SW, Thomas ED (1987) Risk factors for airflow obstruction in recipients of bone marrow transplants. Ann Intern Med 107:648–656

    PubMed  CAS  Google Scholar 

  6. El-Khatib M, Bou-Khalil P, Abbas O, Salman A, Jamaleddine G (2007) Value of pretransplant pulmonary function tests in predicting pulmonary complications after autologous peripheral stem cell transplantation. Lung 185:321–324

    Article  PubMed  Google Scholar 

  7. Savani BN, Montero A, Srinivasan R, Singh A, Shenoy A, Mielke S et al (2006) Chronic GVHD and pretransplantation abnormalities in pulmonary function are the main determinants predicting worsening pulmonary function in long-term survivors after stem cell transplantation. Biol Blood Marrow Transplant 12:1261–1269

    Article  PubMed  Google Scholar 

  8. Chien JW, Martin PJ, Gooley TA, Flowers ME, Heckbert SR, Nichols WG et al (2003) Airflow obstruction after myeloablative allogeneic hematopoietic stem cell transplantation. Am J Respir Crit Care Med 168:208–214

    Article  PubMed  Google Scholar 

  9. Chien JW, Madtes DK, Clark JG (2005) Pulmonary function testing prior to hematopoietic stem cell transplantation. Bone Marrow Transplant 35:429–435

    Article  PubMed  CAS  Google Scholar 

  10. Ghalie R, Szidon JP, Thompson L, Nawas YN, Dolce A, Kaizer H (1992) Evaluation of pulmonary complications after bone marrow transplantation: the role of pretransplant pulmonary function tests. Bone Marrow Transplant 10:359–365

    PubMed  CAS  Google Scholar 

  11. Lee MY, Chiou TJ, Yang MH, Bai LY, Hsiao LT, Chao TC et al (2005) Relatively favorable outcomes of post-transplant pulmonary function in patients with chronic myeloid leukemia receiving non-myeloablative allogeneic hematopoietic stem cell transplantation. Eur J Haematol 74:152–157

    Article  PubMed  CAS  Google Scholar 

  12. Goldberg SL, Klumpp TR, Magdalinski AJ, Mangan KF (1998) Value of the pretransplant evaluation in predicting toxic day-100 mortality among blood stem-cell and bone marrow transplant recipients. J Clin Oncol 16:3796–3802

    PubMed  CAS  Google Scholar 

  13. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG et al (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106:2912–2919

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported in part by a grant for clinical cancer research from the Ministry of Health, Labor and Welfare of Japan. We would like to thank the staff of the Hematology Division at Tokyo Metropolitan Cancer and the Infectious Diseases Center, Komagome Hospital, for their excellent patient care.

Conflict of interest

The authors declare no competing financial interests.

Author information

Authors and Affiliations

  1. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113–8677, Japan

    Kazuhiko Kakihana, Kazuteru Ohashi, Yutaka Murata, Takeshi Kobayashi, Takuya Yamashita, Hisashi Sakamaki & Hideki Akiyama

  2. Pharmacy Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Yuka Hirashima

Authors
  1. Kazuhiko Kakihana
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuteru Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuka Hirashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yutaka Murata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takeshi Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takuya Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hisashi Sakamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hideki Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuhiko Kakihana.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kakihana, K., Ohashi, K., Hirashima, Y. et al. Clinical Impact of Pre-transplant Pulmonary Impairment on Survival After Allogeneic Hematopoietic Stem Cell Transplantation. Pathol. Oncol. Res. 18, 11–16 (2012). https://doi.org/10.1007/s12253-011-9383-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12253-011-9383-x

Keywords

Search

Navigation