Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
Leuk Lymphoma. 2023 Dec;64(14):2279-2285. doi: 10.1080/10428194.2023.2256912. Epub 2023 Sep 10.
This study aims to evaluate the predictive value of routine pulmonary function testing (PFT) at the 12-month mark post-autologous hematopoietic cell transplant (AHCT) in identifying clinically significant lung disease in lymphoma survivors. In 247 patients, 173 (70%) received BEAM (carmustine, etoposide, cytarabine, melphalan), and 49 (20%) received TBC (thiotepa, busulfan, cyclophosphamide) conditioning regimens. Abnormal baseline PFT was noted in 149 patients (60%). Thirty-four patients had a significant decline (reduction of >/= 20% in DLCO or FEV1 or FVC) in post-AHCT PFT, with the highest incidence in the CNS lymphoma group (39%). The incidence of clinically significant lung disease post-transplant was low at 2% and there was no association between abnormal pre- and 1-year post-transplant PFTs with the development of clinical lung disease. While this study illustrates the impact of treatment regimens on PFT changes, it did not demonstrate a predictive value of scheduled PFTs in identifying clinically significant post-AHCT lung disease.
本研究旨在评估自体造血细胞移植(AHCT)后 12 个月常规肺功能测试(PFT)对淋巴瘤幸存者中临床显著肺部疾病的预测价值。在 247 例患者中,173 例(70%)接受了 BEAM(卡莫司汀、依托泊苷、阿糖胞苷、马法兰)预处理方案,49 例(20%)接受了 TBC(噻替哌、白消安、环磷酰胺)预处理方案。149 例患者(60%)存在基线 PFT 异常。34 例患者在 AHCT 后 PFT 中出现显著下降(DLCO 或 FEV1 或 FVC 降低>/=20%),中枢神经系统淋巴瘤组发生率最高(39%)。移植后临床显著肺部疾病的发生率较低,为 2%,且异常的 PFT 与移植后 1 年内的临床肺部疾病的发生之间无相关性。虽然本研究说明了治疗方案对 PFT 变化的影响,但并未证明定期 PFT 对识别临床显著的 AHCT 后肺部疾病具有预测价值。