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Influence of Pretransplant Restrictive Lung Disease on Allogeneic Hematopoietic Cell Transplantation Outcomes

Ramirez-Sarmiento, Alba and Orozco-Lev, Mauricio and Walter, Eric C. and Au, Margaret A. and Chien, Jason W. (2010) Influence of Pretransplant Restrictive Lung Disease on Allogeneic Hematopoietic Cell Transplantation Outcomes. Biology of Blood and Marrow Transplantation, 16 (2). pp. 199-206. ISSN 1083-8791

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Article URL: http://dx.doi.org/10.1016/j.bbmt.2009.09.016

Abstract

We conducted a 15-year retrospective cohort study to determine the prevalence of restrictive lung disease prior to allogeneic hematopoietic cell transplant (HCT), and to assess whether this was a risk factor for poor outcomes. 2545 patients were eligible for the analysis. Restrictive lung disease was defined as a total lung capacity (TLC) <80% of predicted normal. Chest x-rays and /or computed tomography scans were reviewed for all restricted patients to determine whether lung parenchymal abnormalities were unlikely or highly likely to cause restriction. Multivariate Cox-proportional hazard and sensitivity analyses were performed to assess the relationship between restriction and early respiratory failure and nonrelapse mortality. Restrictive lung disease was present in 194 subjects (7.6%) prior to transplantation. Among these cases, radiographically apparent abnormalities were unlikely to be the cause of the restriction in 149 (77%) subjects. In unadjusted and adjusted analyses, the presence of pulmonary restriction was significantly associated with a 2-fold increase in risk for early respiratory failure and nonrelapse mortality, suggesting that these outcomes occurring in the absence of radiographically apparent abnormalities may be related to respiratory muscle weakness. These findings suggest that pulmonary restriction should be considered as a risk factor for poor outcomes after transplant.

Item Type: Article
Additional Information: This article is available to subscribers only via the URL above.
DOI: 10.1016/j.bbmt.2009.09.016
PubMed ID: 19781655
NIHMSID: NIHMS148279
PMCID: PMC2819577
Grant Numbers: BA06/90061, RTIC- C03/11, Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain, BMTH4-CT98-3406, EU, HL088201
Keywords or MeSH Headings: * Adult * Cohort Studies * Hematopoietic Stem Cell Transplantation*/mortality * Humans * Lung Diseases, Interstitial/complications* * Lung Diseases, Interstitial/epidemiology * Lung Diseases, Obstructive/complications* * Lung Diseases, Obstructive/epidemiology * Male * Middle Aged * Prevalence * Respiratory Function Tests * Respiratory Insufficiency/etiology * Retrospective Studies * Risk Factors * Statistics as Topic * Treatment Outcome
Subjects: Diseases
Research Methodologies > Epidemiology > Risk assessment
Therapeutics > Transplantation > Stem Cell transplantation
Depositing User: Library Staff
Date Deposited: 30 Sep 2009 22:13
Last Modified: 14 Feb 2012 14:42
URI: http://authors.fhcrc.org/id/eprint/336

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