Abstract
Respiratory pathology is common following allogeneic haematopoietic stem cell transplantation (HSCT). Respiratory function test (RFT) declines post HSCT may be progressive and irreversible, contributing significantly to morbidity and mortality. Frequent RFT follow-up is essential for early detection and management of pulmonary complications. Different groups, including ours, have previously reported that FEV1 declines of >10% are common and may be reversible. This study sought to identify factors associated with RFT decline post allogeneic HSCT in our cohort.
Spirometry data from routine follow-up was collected from patients undergoing HSCT between Jan 2005 - Dec 2013 and survived to 1 year without relapse. Post HSCT FEV1 declines of >10% and subsequent recovery to within 10% of baseline were compared with pre-transplant factors: age, gender, smoking history, indication, pre-transplant RFT, cell source and use of anti-thymocyte globulin (ATG) during conditioning. Kaplan-Meier estimates were used to compare associations with FEV1 decline and recovery, Cox regression was used to determine hazard ratios (HRs). This study was approved by the Local Human Research Ethics Committee.
After excluding patients with incomplete data or < 3 RFT in 12 months, 94 subjects were included. Patients receiving peripheral blood stem cells were more likely to exhibit a >10% FEV1 decline compared with bone marrow (P<0.01, HR: 5.6, 95% CI: 1.4-22.8). Patients receiving ATG appeared equally likely to exhibit an FEV1 decline compared to those not, but this decline was more likely to be reversible (P<0.05, HR: 3.1, 95% CI: 1.2-7.9).
Stem cell source and use of ATG may affect respiratory function following allogeneic HSCT.
- Copyright ©the authors 2016
