Pulmonary function after autologous bone marrow transplantation in children: a long-term prospective study

Frisk, Per; Arvidson, Johan; Bratteby, Lars‐Eric; Hedenström, Hans; Lönnerholm, Gudmar

doi:10.1038/sj.bmt.1704393

Cited by 56 publications

(41 citation statements)

References 20 publications

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“…Patients treated for leukemia had the lowest proportion of lung impairment (less than 10%). That is in concordance with other reports on long-term survivors of leukemia, where risk factors for lung damage were bone marrow transplantation, total body RT and spinal RT (8,13,14,17,18,24).…”

Section: Discussionsupporting

confidence: 81%

“…Clinically, from 10% to 98% of these subjects are asymptomatic (6,8,13,14,15). Especially high incidence of restrictive (up to 47%) and diffusion lung function disorders (up to 62%) is common after bone marrow transplantation, being higher in patients treated with total body irradiation and/or experiencing graftversus-host disease (13,(16)(17)(18). There are some reports that the detected abnormalities did not progress over the time of follow-up (17,19).…”

Section: Introductionmentioning

confidence: 99%

“…Especially high incidence of restrictive (up to 47%) and diffusion lung function disorders (up to 62%) is common after bone marrow transplantation, being higher in patients treated with total body irradiation and/or experiencing graftversus-host disease (13,(16)(17)(18). There are some reports that the detected abnormalities did not progress over the time of follow-up (17,19). Children below 3 years of age at the time of treatment seem to be at higher risk to develop late pulmonary sequelae (18).…”

Section: Introductionmentioning

confidence: 99%

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Late Pulmonary Sequelae After Treatment of Childhood Cancer

2014

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Objective -Increasingly successful treatment of childhood cancer during the last decades, resulting in a number of long term survivors, has made it possible to study late sequelae of this treatment in sizable cohorts of survivors. The aims were to determine the frequency and severity of pulmonary late sequelae among children treated for cancer to identify treatment risk factors and the methods for continued followup. Materials and methods -In 255 of the 1020 survivors, at least 18 years old, 5 years after treatment, who agreed with the examination protocol, testing was performed at the time of their follow up appointment. It was conducted 5 to 37 (mean 18) years after diagnosis. The examinations included physical examination, chest radiograms and pulmonary function testing. Results -Radiograms revealed 79 abnormalities in 53 patients and were most frequently found in patients with Hodgkin's disease (20/67) or non-Hodgkin's lymphoma treated with mediastinal radiotherapy (RT) (10/31), in patients with brain tumor treated with RT to the central nervous axis (CNA) (7/15), in Wilms' tumor patients, who had abdominal RT, scoliosis was found. (6/15). Lung function tests showed abnormal values, mostly restrictive changes, in 59 of 237 patients. Conclusion -Late pulmonary sequelae after treatment of childhood cancer are rare serious or life-threatening complications. Radiographic and pulmonary function abnormalities were most frequently found in patients who had mediastinal or CNA RT. Regular follow-up of these patients is therefore recommended. Spirometry has been a useful test for detection of pulmonary sequelae. Routinely follow-up radiography is always indicated in clinical suspicion of secondary tumors.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Late Pulmonary Sequelae After Treatment of Childhood Cancer

2014

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“…Pulmonary dysfunction after HSCT has been described and may occur especially in children with BU or TBI as part of the conditioning regimen. [17][18][19][20][21] The second most prevalent late effect was endocrine toxicity, involving growth, gonadal function/infertility and hypothyroidism. Endocrine late effects are more common in HSCT survivors who had TBI/TAI as part of their conditioning regimen, but gonadal dysfunction and infertility is also highly prevalent after conditioning regimens with a combination of alkylating cytotoxic drugs (BU, CY, melphalan (Mel)).…”

Section: Discussionmentioning

confidence: 99%

High burden of late effects after haematopoietic stem cell transplantation in childhood: a single-centre study

Bresters

Gils

Kollen

et al. 2009

Bone Marrow Transplant

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The aim of our study was to assess the cumulative incidence and severity ('burden') of late effects in a single-centre cohort of childhood haematopoietic stem cell transplantation (HSCT) survivors, at least 2 years after transplantation. The presence and severity of late effects in each survivor was documented according to the Common Terminology Criteria for Adverse Events (version 3.0). The burden of late effects was graded from mild to disabling/life-threatening. Risk factors for a high burden of late effects were assessed by univariate and multivariate logistic regression analyses. Among 162 survivors of HSCT seen in our late effects outpatient clinic, cumulative incidence of late effects was 93.2% after a median followup time of 7.2 years (range 2.0-21.0 years) after HSCT. The burden of late effects was mild, moderate, severe and disabling in 28, 41, 24 and 1% of survivors respectively. Risk factors for a severe or disabling burden of late effects were older age at HSCT (P for trend o0.001) and a conditioning regimen including irradiation OR 2.2, 95% CI 1.1-4.7, P ¼ 0.03). In conclusion, a high burden of late effects is found in childhood HSCT survivors after a median follow-up of only 7 years.

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“…Consistent with previously reports, our patients with BrOb/ BOS experienced a 40% nonrelapse mortality, significantly greater than those without BrOb/BOS. 2,5,[16][17][18][19][20][21][22][23] Thus, clinical trials of new or novel therapies are essential, including agents with anti-inflammatory properties such as azithromycin or pravastatin that have more tolerable toxicity profiles and potentially additive therapeutic benefit when combined with current treatment modalities.…”

Section: Discussionmentioning

confidence: 99%