454 Decreased Pulmonary Function in Asymptomatic Long Term Survivors After Busulfan-Based Myeloablative Allogeneic Hematopoietic Stem Cell Transplant

Track: Contributed Abstracts
Saturday, February 16, 2013, 6:45 PM-7:45 PM
Hall 1 (Salt Palace Convention Center)
Annie Oh, MD , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
Pritesh Patel, MB, ChB , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
Santosh Saraf, M.D. , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
Karen Sweiss, PharmD, BCOP , Pharmacy, University of Illinois Hospital & Health Sciences System, Chicago, IL
David Peace, MD , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
John Quigley, MD , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
Nadim Mahmud, MD, PhD , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL
Steven Dudek, MD , Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Hospital & Health Sciences System, Chicago, IL
Damiano Rondelli, MD , Section of Hematology/Oncology, University of Illinois Hospital & Health Sciences System, Chicago, IL

Pulmonary function post allogeneic hematopoietic stem cell transplant (HSCT) can be impaired by previous exposure to chemotherapy, infection, or graft versus host disease (GVHD).� In this retrospective study, we analyzed 21 patients with hematologic malignancies who are long term transplant survivors with a median follow-up of 48 months who had received a related (60%) or unrelated (40%) HSCT conditioned with a busulfan-based regimen. Of 21 patients, 7 are of Caucasian and 14 non-Caucasian ethnicity. All patients had routine pulmonary function tests (PFTs) repeated within two years from transplant and none had underlying lung disease.� To eliminate inter-lab variability, all PFTs were performed in the same laboratory.� Survival rate at the time of analysis was 90%.

We initially compared single parameters of PFTs including corrected diffusion limiting capacity of oxygen (DLCO), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and total lung capacity (TLC) obtained before and after transplant.� Post transplant, all PFT parameters showed some degree of reduction compared to pre-transplant values. FEV1 and FEV1/FVC were significantly decreased (108 vs 92, p=0.04 and 86 vs 80%, p=0.04, respectively), with no difference between Caucasian and non-Caucasians.� Overall, median values of corrected DLCO and TLC prior to and after transplant were only slightly reduced. However, in non-Caucasian patients a significant reduction of DLCO was observed (93%�31 vs 73%�11, p=0.05).

We analyzed intra-patient changes in DLCO and FEV1 values and no correlation was found between these parameters and the development of chronic GVHD.�

This study shows an overall decrease in pulmonary function in patients without apparent lung disease following a myeloablative busulfan-based HSCT.� However, a higher risk of a reduced DLCO was noted only among non-Caucasian patients. At this time it is not known if this observation is due to genetic, biologic or environmental causes.

See more of: Poster Session 2: GVH/GVL
See more of: Contributed Abstracts
<< Previous Abstract | Next Abstract >>