Pulmonary dysfunction in survivors of childhood hematologic malignancies after allogeneic hematopoietic stem cell transplantation

Inaba, Hiroto; Yang, Jie; Pan, Jianmin; Stokes, Dennis C.; Krasin, Matthew J.; Srinivasan, Ashok; Hartford, Christine; Pui, Ching‐Hon; Leung, Wing

doi:10.1002/cncr.24897

Cited by 52 publications

(65 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We confirmed that patients with refractory disease had significantly worse PFTs post-aHSCT compared with patients in complete remission or patients with nonmalignant disease. 6,11,12 We did not find any significant correlation between age, CMV status, or earlier pulmonary-toxic chemotherapy and pre/post-aHSCT lung function parameters, morbidity, or mortality. In a study of 90 pediatric aHSCT recipients, Lee et al 13 reported on the respiratory failure and mortality 5 of 6 patients with suspected or confirmed CMV pneumonia.…”

Section: Discussionmentioning

confidence: 51%

Lung Function Before and After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation

Quigg¹,

Kim

Goebel³

et al. 2012

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Background Pre-allogeneic hematopoietic stem cell transplantation (aHSCT) and post-aHSCT lung function of 41 eligible patients at Riley Hospital for Children were assessed to identify risk factors for post-aHSCT morbidity and mortality. Observations One year post-aHSCT pulmonary function tests were significantly lower compared with baseline. These findings recovered at 2 years post-aHSCT. Refractory disease before aHSCT correlated with lower pulmonary function tests after aHSCT. Graft-versus-host disease was significantly associated with higher post-aHSCT residual volume. Importantly, low pre-aHSCT carbon monoxide diffusing capacity adjusted for hemoglobin and alveolar volume was predictive of death. Conclusions Among survivors, lung function improves over time after pediatric aHSCT. Measurement of carbon monoxide diffusing capacity adjusted for hemoglobin and alveolar volume before pediatric aHSCT should be further investigated as a predictor of pulmonary dysfunction and mortality.

show abstract

Section: Discussionmentioning

confidence: 51%

Lung Function Before and After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation

Quigg¹,

Kim

Goebel³

et al. 2012

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

show abstract

“…The natural history of pulmonary function impairment has not been well recognised. Recently, Inaba et al 9 investigated the pattern of pulmonary dysfunction over time in 89 CCSs. They showed that pulmonary function progressively declined.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function impairment measured by pulmonary function tests in long-term survivors of childhood cancer

Mulder

Thönissen

Pal

et al. 2011

Thorax

View full text Add to dashboard Cite

Background Childhood cancer survivors (CCSs) have an increased risk of morbidity and mortality. The prevalence and risk factors of pulmonary function impairment were investigated in a large cohort of CCSs treated with potentially pulmotoxic therapy with a minimal follow-up of 5 years after diagnosis. Methods The study cohort consisted of all adult 5-year CCSs who were treated with bleomycin, pulmonary radiotherapy and/or pulmonary surgery in the Emma Children's Hospital/Academic Medical Center between 1966 and 1996. Pulmonary function tests were performed to diagnose obstructive and restrictive pulmonary function impairment, and diffusion capacity impairment.Results The study population consisted of 220 out of 248 eligible CCSs, of whom 193 (87.7%) had performed a pulmonary function test at a median follow-up of 18 years after diagnosis. 85 (44.0%) out of 193 CCSs developed a pulmonary function impairment. Pulmonary function impairments occurred in all treatment groups. Most prevalent were restrictive pulmonary function impairment (17.6%) and a decreased carbon monoxide diffusion capacity (39.9%). Multivariate logistic regression models showed that, compared with bleomycin treatment only, treatment with radiotherapy, radiotherapy combined with bleomycin and radiotherapy combined with surgery were associated with the highest risk of pulmonary function impairment. Conclusions The prevalence of pulmonary function impairment in long-term adult CCSs who received potentially pulmotoxic therapy is high. Bleomycin, pulmonary radiotherapy and pulmonary surgery are all associated with pulmonary function impairment. Pulmonary radiotherapy, especially in combination with bleomycin or surgery, is the most important risk factor. This emphasises the need for adequate counselling and follow-up for this patient population.

show abstract

“…43,45,46,48,49,52,55,99 The most commonly reported fi nding is a restrictive ventilatory defi cit, sometimes associated with a decrease in D lco . 40,42,43,45,[47][48][49]50,51,[53][54][55]58 In a cohort of survivors of childhood hematologic malignancies after allogeneic HSCT (n 5 89), Inaba et al 62 showed progressive worsening of pulmonary function measured with forced midexpiratory fl ow (25%-75%), residual volume, TLC, and D lco during a median follow-up of 8.9 years.…”

Section: Other Risk-based Factors For Lung Damagementioning

confidence: 99%

Pulmonary Outcomes in Survivors of Childhood Cancer

Huang

Hudson

Stokes

et al. 2011

Chest

Self Cite

136

137

View full text Add to dashboard Cite

O ver the last 3 decades, therapeutic progress has resulted in a growing population of survivors of childhood cancer. In 2006, there were Ͼ 11 million cancer survivors in the United States, three times the number of survivors in 1971. 1 The 5-year survival rate for children diagnosed with cancer is approaching 85%, 2 and an estimated one in 570 individuals in the United States between the ages of 20 and 34 is a survivor of childhood cancer. 3 Unfortunately, increased survival rates are not without consequences. There is substantial evidence Background: The purpose of this article is to summarize the literature that documents the longterm impact of cancer treatment modalities on pulmonary function among survivors of cancer and to identify potential areas for further research. Methods: Systematic reviews of clinical trials, observational studies, case series, and review articles were conducted. Articles were limited to the studies that discussed pulmonary toxicity or late effects among pediatric cancer survivors and to follow-up investigations that were conducted a minimum of 2 years after completion of cancer-related treatment or 1 year after hematopoietic stem cell transplant. Results: Sixty publications (51 clinical studies/reports and nine reviews) published from January 1970 to June 2010 in PubMed met the inclusion criteria. Data showed an association between radiotherapy, alkylating agents, bleomycin, hematopoietic stem cell transplant, and thoracic surgery and pulmonary toxicity, as well as possible interactions among these modalities. Conclusions: Pulmonary toxicity is a common long-term complication of exposure to certain anticancer therapies in childhood and can vary from subclinical to life threatening. Pulmonary function and associated loss of optimal exercise capacity may have adverse effects on long-term quality of life in survivors. Lung function diminishes as a function of normal aging, and the effects of early lung injury from cancer therapy may compound these changes. The information presented in this review is designed to provide a stimulus to promote both observational and interventional research that expands our knowledge and aids in the design of interventions to prevent or ameliorate pulmonary late effects among survivors of childhood cancer. CHEST 2011; 140(4):881-901Abbreviations: ALL 5 acute lymphoblastic leukemia; BCNU 5 carmustine; CCNU 5 lomustine; D lco 5 diffusing capacity of the lung for carbon monoxide; GVHD 5 graft-vs-host disease; gy 5 gray; HL 5 Hodgkin's lymphoma; HSCT 5 hematopoietic stem cell transplant; NHL 5 non-Hodgkin's lymphoma; PFT 5 pulmonary function testing; TLC 5 total lung capacity

show abstract

Pulmonary dysfunction in survivors of childhood hematologic malignancies after allogeneic hematopoietic stem cell transplantation

Cited by 52 publications

References 25 publications

Lung Function Before and After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation

Lung Function Before and After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation

Pulmonary function impairment measured by pulmonary function tests in long-term survivors of childhood cancer

Pulmonary Outcomes in Survivors of Childhood Cancer

Contact Info

Product

Resources

About