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Pulmonary function after autologous bone marrow transplantation in children: a long-term prospective study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
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2004 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 33, 645-650 p.Article in journal (Refereed) Published
Abstract [en]

We performed serial pulmonary function tests (PFTs) consisting of spirometry and diffusing capacity in 26 children after BMT. The median follow-up was 10 years. The influence of total body irradiation (TBI) on long-term pulmonary function was of particular interest. In the 20 children who had received TBI, after an initial decrease the PFTs showed recovery, but the mean lung volumes were still significantly decreased 5 years after BMT at 10% below baseline. The proportions of children with restrictive impairment 5 and 10 years after BMT were 20 and 21%, respectively. Only one child was diagnosed with obstructive impairment. The proportions of children with isolated diffusing impairment at 5 and 10 years were 7/20 (35%) and 7/13 (54%), respectively. Six children had received chemotherapy only and showed isolated diffusing impairment as the only long-term sequela in 4/5 and 1/3 at 5 and 10 years. Our main finding was that there was little change in PFTs 1–10 years after BMT. TBI was associated with persistently decreased lung volumes in a proportion of patients, whereas chemotherapy also might have been of importance for the development of impaired gas exchange.

Place, publisher, year, edition, pages
2004. Vol. 33, 645-650 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-90960DOI: 10.1038/sj.bmt.1704393PubMedID: 14688819OAI: oai:DiVA.org:uu-90960DiVA: diva2:163501
Available from: 2003-10-30 Created: 2003-10-30 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Late Effects After Autologous Bone Marrow Transplantation in Childhood
Open this publication in new window or tab >>Late Effects After Autologous Bone Marrow Transplantation in Childhood
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Fifty children with hematologic malignancies have been treated with autologous BMT in Uppsala. The aim was to describe late effects in this group with special reference to cataracts, reduced final height, and to hepatic, renal, and pulmonary late effects.

Cataracts: All patients who received TBI in their conditioning developed posterior subcapsular cataract after BMT. A few patients with visual impairment affecting daily life needed cataract surgery, whereas the visual acuity was well preserved in most of the other patients.

Final height: There was a decrease in final height relative both to height at BMT and to target height. This decrease was significant both in those who had received TBI only and in those who had been given cranial irradiation. Cranial irradiation, young age at BMT, and short duration of GH treatment were predictors of height loss.

Hepatic function: Hepatic function was well preserved over a period of 10 years after BMT. TBI did not appear to be a risk factor for hepatic impairment.

Renal function: Six months after BMT there was a decrease in renal function in patients who had received TBI. It then recovered, albeit incompletely, and stabilized. After the first year there was little change over a period of 10 years after BMT. TBI appeared to be the most important risk factor for the development of chronic renal impairment in a number of patients. Nephrotoxic antibiotics may have contributed.

Pulmonary function: Six months after BMT there was a decrease in pulmonary function in those who received TBI. It then recovered and stabilized at the pretransplant level. After the first year there was little change over a period of 10 years after BMT. TBI appeared to be the most important risk factor for restrictive pulmonary disease in a number of patients whereas chemotherapy might also have been of importance for impaired gas exchange.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 63 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1293
Keyword
Pediatrics, bone marrow transplantation, children, follow-up, cataracts, final height, pubertal development, hepatic function, renal function, pulmonary function, Pediatrik
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-3673 (URN)91-554-5767-3 (ISBN)
Public defence
2003-11-21, Rosénsalen, Akademiska barnsjukhuset, 751 85 Uppsala, 09:15
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Supervisors
Available from: 2003-10-30 Created: 2003-10-30Bibliographically approved

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Frisk, PerArvidson, JohanBratteby, Lars-EricHedenström, HansLönnerholm, Gudmar

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