Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon.
Bone Marrow Transplant Program, Division of Hematology and Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
Clin Lymphoma Myeloma Leuk. 2020 Jun;20(6):371-376.e1. doi: 10.1016/j.clml.2019.10.015. Epub 2019 Oct 23.
Most studies addressing the impact of hematopoietic stem cell transplantation (SCT) on pulmonary function test (PFT), and the various factors affecting that impact have been performed on the allogenic type. Few have addressed PFT changes in autologous SCT. This study describes PFT changes seen in autologous SCT recipients and addresses the various factors impacting these changes.
We reviewed the medical records of 223 consecutive adult autologous SCT recipients. We collected pre-transplant and post-transplant data, as well as PFT data and long-term mortality.
A total of 123 patients with lymphoma receiving the BEAM (carmustine, etoposide, aracytin, and melphalan) conditioning regimen had a significant 5% drop in mean forced vital capacity and total lung capacity but no significant change in forced expiratory volume in one second/forced vital capacity ratio nor in diffusion lung capacity of carbon monoxide adjusted to volume. Fifteen percent of the patients with lymphoma had a clinically significant drop of 15% in their lung volume parameters. The patients with multiple myeloma receiving the melphalan conditioning regimen had no significant change in any of the PFT parameters. Smoking, baseline PFT parameters, and radiation did not affect lung function or mortality.
Autologous SCT impact on lung function depends on the disease and conditioning regimen. It leads to a drop in lung volumes but no obstruction or decrease in diffusion in patients with lymphoma receiving the BEAM regimen. Autologous SCT did not affect lung functions in patients with multiple myeloma, and these patients may not need screening PFTs.
大多数研究都针对异基因造血干细胞移植（SCT）对肺功能测试（PFT）的影响以及影响这种影响的各种因素进行了探讨，而很少有研究涉及自体 SCT 的 PFT 变化。本研究描述了自体 SCT 受者的 PFT 变化，并探讨了影响这些变化的各种因素。
我们回顾了 223 例连续成人自体 SCT 受者的病历。我们收集了移植前和移植后的资料以及 PFT 资料和长期死亡率。
共有 123 例接受 BEAM（卡莫司汀、依托泊苷、阿糖胞苷和马法兰）预处理方案的淋巴瘤患者平均用力肺活量和肺总量下降了 5%，但用力呼气量一秒率/用力肺活量比值和一氧化碳弥散量调整为体积均无显著变化。15%的淋巴瘤患者肺容积参数出现了有临床意义的 15%下降。接受马法兰预处理方案的多发性骨髓瘤患者 PFT 各参数无显著变化。吸烟、基线 PFT 参数和放疗均未影响肺功能或死亡率。
自体 SCT 对肺功能的影响取决于疾病和预处理方案。它会导致淋巴瘤患者接受 BEAM 方案时的肺容积下降，但不会导致阻塞或弥散功能下降。自体 SCT 对多发性骨髓瘤患者的肺功能没有影响，这些患者可能不需要进行 PFT 筛查。
