Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease
- Department of Haematology, Royal Infirmary, Glasgow (Scotland)
Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p less than 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, as measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p less than 0.01). Both were related, at least in part, to the presence of GVHD (p less than 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p less than 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients.
- OSTI ID:
- 5396029
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics; (United States), Vol. 20:6; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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BONE MARROW CELLS
TRANSPLANTS
RESPIRATORY SYSTEM DISEASES
RADIOINDUCTION
FRACTIONATED IRRADIATION
GRAFT-HOST REACTION
LEUKEMIA
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WHOLE-BODY IRRADIATION
ANIMAL CELLS
CONNECTIVE TISSUE CELLS
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EXTERNAL IRRADIATION
IMMUNE SYSTEM DISEASES
IRRADIATION
NEOPLASMS
SOMATIC CELLS
560151* - Radiation Effects on Animals- Man