LUNG-FUNCTION AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR LEUKEMIA OR LYMPHOMA

Longitudinal data were analysed on the lung function of 25 of 29 survi vors of childhood leukaemia or lymphoma, who had been conditioned with cyclophosphamide and total body irradiation before allogeneic bone ma rrow transplantation, to test whether children are particularly vulner able to pulmonary damage after transplantation. None developed chronic graft-versus-host disease. Transfer factor and lung volumes were redu ced immediately after bone marrow transplantation, but increased durin g the following years. However, at the last follow up, 4-13 years (med ian 8) after transplantation, patients had significantly reduced trans fer factor, total lung capacity, and forced vital capacity (-1.0, -1.2 , and -0.8 SD score, respectively), and increased ratio of forced expi ratory volume in one second to forced vital capacity (+0.9 SD score). None of the patients had pulmonary symptoms, and changes were unrelate d to their age at bone marrow transplantation. In conclusion, patients had subclinical restrictive pulmonary disease at a median of eight ye ars after total body irradiation and allogeneic bone marrow transplant ation.