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Obstructive lung disease in children after allogeneic bone marrow transplantation

Authors :
Kirk Schultz
Gj, Green
Wensley D
Ma, Sargent
Jf, Magee
Jj, Spinelli
Pritchard S
Jh, Davis
Pc, Rogers
Kw, Chan
Source :
Europe PubMed Central
Publication Year :
1994
Publisher :
American Society of Hematology, 1994.

Abstract

Obstructive lung disease (OLD) has been described as a significant complication after allogeneic bone marrow transplantation (BMT). The incidence of OLD in adults appears to be low (approximately 3%), but there is little data for children. We analyzed 89 consecutive pediatric allogeneic BMTs, > or = 1.5 years post-BMT, performed at British Columbia's Children's Hospital from 1980 to 1992 for evidence of OLD. Diagnosis of OLD was based on clinical findings (nonproductive cough, wheezing, and dyspnea with no evidence of infection), pulmonary function tests (FEV1 < 80% and FEF25–75% < 60% predicted), lung biopsy, and computed tomography scan. Sixty-seven of the 89 children evaluated survived > or = 90 days and were classified as at risk for OLD. Thirteen of 67 (19.4%), developed OLD, 3 of which were transient. The development of OLD was strongly associated with the following high-risk groups: chronic graft-versus-host disease (GVHD) (37.1% OLD), increased donor age, acute GVHD, and either mismatched related or matched unrelated donor transplants. No correlation was found with methotrexate prophylaxis for GVHD, total body irradiation, or cytomegalovirus reactivity in either donor or recipient and the development of OLD. Further analysis of only children with chronic GVHD showed that liver involvement by GVHD before the onset of OLD (57.9%) was the only other significant predictive factor. We observed an overall increased prevalence of OLD in children compared with that previously reported in adults. Further studies are required to confirm whether age is a risk factor for development of OLD after allogeneic BMT.

Details

ISSN :
15280020 and 00064971
Volume :
84
Database :
OpenAIRE
Journal :
Blood
Accession number :
edsair.doi.dedup.....d88621b5ebe985a32a7a28821b2c4a21
Full Text :
https://doi.org/10.1182/blood.v84.9.3212.3212