Longitudinal lung function in childhood cancer survivors after hematopoietic stem cell transplantation

Longitudinal data on pulmonary function after pediatric allogeneic or autologous hematopoietic stem cell transplantation (HSCT) are rare. We examined pulmonary function and associated risk factors in 5-year childhood cancer survivors (CCSs) longitudinally. We included 74 CCSs diagnosed between 1976...

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Bibliographic Details
Published in:Bone marrow transplantation (Basingstoke) 2022-02, Vol.57 (2), p.207-214
Main Authors: Otth, Maria, Yammine, Sophie, Usemann, Jakob, Latzin, Philipp, Mader, Luzius, Spycher, Ben, Güngör, Tayfun, Scheinemann, Katrin, Kuehni, Claudia E.
Format: Article
Language:English
Subjects:
692/308/174
692/699/67
692/700/1720
Autografts
Cancer
Cancer Survivors
Carbon monoxide
Cell Biology
Child
Childhood
Children
Etiology
Female
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Humans
Internal Medicine
Lung
Lung cancer
Lungs
Medicine
Medicine & Public Health
Neoplasms
Pediatrics
Prospective Studies
Public Health
Pulmonary functions
Radiation therapy
Regression analysis
Respiratory function
Risk analysis
Risk factors
Stem cell transplantation
Stem Cells
Survival
Transplantation
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Summary:Longitudinal data on pulmonary function after pediatric allogeneic or autologous hematopoietic stem cell transplantation (HSCT) are rare. We examined pulmonary function and associated risk factors in 5-year childhood cancer survivors (CCSs) longitudinally. We included 74 CCSs diagnosed between 1976 and 2010, treated with HSCT, and with at least two pulmonary function tests performed during follow-up. Median follow-up was 9 years (range 6–13). We described pulmonary function as z-scores for lung volumes (forced vital capacity [FVC], residual volume [RV], total lung capacity [TLC]), flows (forced expiratory volume in 1 s [FEV1], maximal mid-expiratory flow [MMEF]), and diffusion capacity for carbon monoxide (DLCO) and assessed associations with potential risk factors using multivariable regression analysis. The median z-scores for FEV1, FVC, and TLC were below the expected throughout the follow-up period. This was not the case for RV, MMEF and DLCO. Female gender, radiotherapy to the chest, and relapse were associated with lower z-scores of FEV1, FVC, MMEF, RV or DLCO. Childhood cancer survivors after HSCT are at risk of pulmonary dysfunction. The complex and multifactorial etiology of pulmonary dysfunction emphasizes the need for longitudinal prospective studies to better characterize the course and causes of pulmonary function impairment in CCSs.
ISSN:0268-3369
1476-5365
1476-5365
DOI:10.1038/s41409-021-01509-1