Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Unidade de Transplante de Medula Óssea, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Hematol Oncol Stem Cell Ther. 2021 Jun;14(2):126-133. doi: 10.1016/j.hemonc.2020.08.004. Epub 2020 Sep 24.
OBJECTIVE/BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a treatment for benign and malignant hematological diseases. These aggressive treatments cause reduced levels of physical activity, decreased lung function, and worse quality of life. Alterations in pulmonary function tests before HSCT are associated with the risk of respiratory failure and early mortality. The objective of this study was to evaluate functional capacity and lung function before and after HSCT and identify the predictors of mortality after 2 years.
A prospective cohort study was carried out with individuals with oncohematological diseases. The evaluations were carried out in two moments during hospitalization and at hospital discharge. Follow-up was carried out after 48 months. Assessments were carried out on 34 adults, using spirometry, manovacuometry, 6-Minute Walk Test (6MWT), Handgrip Strength Test, and 30-Second Chair Stand Test (30-s CST).
There was a statistically significant reduction for the variables in forced vital capacity, forced expiratory volume predicted in the 1st second, Tiffeneau index, handgrip strength, and distance covered (% predicted) on the 6MWT (p < .05). There was a significant difference in the 30-s CST when individuals were compared according to the type of transplant. We found that a 10% reduction in the values of maximum inspiratory pressure (MIP) can predict an increased risk for mortality.
Individuals undergoing HSCT have reduced functional capacity, lung function, and muscle strength during the hospitalization phase. Reduction in the values of MIP increases the risk of nonrelapse mortality.
目的/背景：造血干细胞移植（HSCT）是治疗良性和恶性血液病的一种方法。这些强化治疗会导致身体活动水平降低、肺功能下降和生活质量下降。HSCT 前肺功能测试的改变与呼吸衰竭和早期死亡的风险相关。本研究的目的是评估 HSCT 前后的功能能力和肺功能，并确定 2 年后死亡的预测因素。
对患有血液恶性肿瘤疾病的个体进行了一项前瞻性队列研究。在住院期间和出院时进行了两次评估。在 48 个月后进行了随访。对 34 名成年人进行了肺量计、手动测压法、6 分钟步行试验（6MWT）、握力测试和 30 秒椅子站立测试（30-s CST）评估。
用力肺活量、第 1 秒用力呼气量预测值、Tiffeneau 指数、握力和 6MWT 覆盖距离（%预测值）等变量均有统计学意义的下降（p < 0.05）。根据移植类型对 30-s CST 进行比较，差异有统计学意义。我们发现，最大吸气压力（MIP）值降低 10%可预测死亡风险增加。
接受 HSCT 的个体在住院期间的功能能力、肺功能和肌肉力量均降低。MIP 值的降低增加了非复发死亡率的风险。
