Nysom K, Holm K, Hesse B, Ulrik C S, Jacobsen N, Bisgaard H, Hertz H
National University Hospital Rigshospitalet, Copenhagen, Denmark.
Arch Dis Child. 1996 May;74(5):432-6. doi: 10.1136/adc.74.5.432.
Longitudinal data were analysed on the lung function of 25 of 29 survivors of childhood leukaemia or lymphoma, who had been conditioned with cyclophosphamide and total body irradiation before allogeneic bone marrow transplantation, to test whether children are particularly vulnerable to pulmonary damage after transplantation. None developed chronic graft-versus-host disease. Transfer factor and lung volumes were reduced immediately after bone marrow transplantation, but increased during the following years. However, at the last follow up, 4-13 years (median 8) after transplantation, patients had significantly reduced transfer factor, total lung capacity, and forced vital capacity (-1.0, -1.2, and -0.8 SD score, respectively), and increased ratio of forced expiratory volume in one second to forced vital capacity (+0.9 SD score). None of the patients had pulmonary symptoms, and changes were unrelated to their age at bone marrow transplantation. In conclusion, patients had subclinical restrictive pulmonary disease at a median of eight years after total body irradiation and allogeneic bone marrow transplantation.
对29名儿童白血病或淋巴瘤幸存者中的25名进行了肺功能纵向数据分析，这些幸存者在异基因骨髓移植前接受了环磷酰胺和全身照射预处理，以测试儿童在移植后是否特别容易受到肺部损伤。无一例发生慢性移植物抗宿主病。骨髓移植后即刻转移因子和肺容量降低，但在随后几年有所增加。然而，在移植后4 - 13年（中位数8年）的最后一次随访中，患者的转移因子、肺总量和用力肺活量显著降低（分别为 - 1.0、 - 1.2和 - 0.8标准差评分），一秒用力呼气量与用力肺活量的比值增加（+0.9标准差评分）。所有患者均无肺部症状，且这些变化与他们骨髓移植时的年龄无关。总之，在全身照射和异基因骨髓移植后中位数8年时，患者存在亚临床限制性肺疾病。
