Shaw N J, Tweeddale P M, Eden O B
Department of Haematology, Royal Hospital for Sick Children.
Med Pediatr Oncol. 1989;17(2):149-54. doi: 10.1002/mpo.2950170215.
Little is known of pulmonary function in survivors of acute lymphoblastic leukaemia (A.L.L.); this is despite the fact that some drugs used, most notably methotrexate, have well-recorded pulmonary toxicity, and the most common infections during therapy in most series are of upper and lower respiratory tract. As part of a survey of all cancer survivors attending the Royal Hospital for Sick Children in Edinburgh, 38 leukaemic patients, who had completed treatment 3 months to 14 years 6 months (median 6 years and 8 months) prior to survey were assessed with regards to their respiratory status. Each patient completed a questionnaire and had spirometry and lung volumes measured; 30 patients additionally had transfer factor for carbon monoxide (TCO) measured. There were 21 children, 11 adults, and 6 patients in the age range between child and adult. Of the 26 adults and children studied with complete data available, 17 (65%) had one or more low values for vital capacity (VC), total lung capacity (TLC), residual volume, or TCO. Mean VC, TLC and TCO were significantly lower than the mean of the predicted values (P less than .001). Gas transfer per unit lung volume (KCO) was normal in all cases. Few patients had symptoms of respiratory disease. There was an increased incidence of low TCO in patients diagnosed under 8 years of age. Impairment of lung growth could be a contributing factor to the observed abnormalities in pulmonary function. Impairment of pulmonary function in survivors of A.L.L. may be of significance for them in later life.
对于急性淋巴细胞白血病（A.L.L.）幸存者的肺功能，人们了解甚少；尽管所使用的一些药物，最显著的是甲氨蝶呤，有记载详细的肺毒性，并且在大多数系列研究中，治疗期间最常见的感染是上呼吸道和下呼吸道感染。作为对所有在爱丁堡皇家儿童医院就诊的癌症幸存者调查的一部分，对38例白血病患者进行了呼吸状况评估，这些患者在调查前3个月至14年6个月（中位时间为6年8个月）完成了治疗。每位患者填写了一份问卷，并进行了肺活量测定和肺容积测量；另外30例患者进行了一氧化碳转运因子（TCO）测量。有21名儿童、11名成人以及6名处于儿童与成人年龄之间的患者。在有完整数据的26名成人和儿童中，17例（65%）的肺活量（VC）、肺总量（TLC）、残气量或TCO中有一项或多项值偏低。平均VC、TLC和TCO显著低于预测值的均值（P小于0.001）。所有病例中每单位肺容积的气体转运（KCO）均正常。很少有患者有呼吸系统疾病症状。8岁以下确诊的患者中TCO偏低的发生率较高。肺生长受损可能是观察到的肺功能异常的一个促成因素。A.L.L.幸存者的肺功能受损对他们的晚年生活可能具有重要意义。
