LATE EFFECTS OF BONE-MARROW TRANSPLANTATION ON PULMONARY-FUNCTION IN CHILDREN

This study was undertaken to evaluate in a primarily pediatric populat ion whether the late effects of bone marrow transplantation (BMT) on p ulmonary function in patients having undergone the procedure for treat ment of acute leukemia or lymphoma are worse than that of patients hav ing undergone transplant for treatment of aplastic anemia. Forty-six p atients were studied. We did not demonstrate statistically significant differences in group mean forced expiratory flow in one second/forced vital capacity (FEV(1)/FVC) and percentage predicted forced expirator y volume in one second (FEV(1)), forced vital capacity (FVC), forced e xpiratory flow at 25-75% of the forced vital capacity (FEF(25-75)) and total lung capacity (TLC) values between the two groups of patients b efore BMT and to 7 years post-transplant. Individual patients with pul monary function abnormalities were identified. Furthermore, there were no significant differences between the two study groups or within the group of patients with aplastic anemia from pre-transplant to 9-12 mo nths and from pre-transplant to 18-24 months after BMT. However, withi n the group of patients treated for acute leukemia or lymphoma, there was a significant decline in the group mean percentage predicted FVC ( p = 0.0001), FEV(1) (p = 0.0006) and FEF(25-75) (p = 0.0063) from pre- transplant to 9-12 months and in the FVC (p = 0.004) and FEV(1) (p = 0 .0006) from pre-transplant to 18-24 months after BMT. The greater decl ine in the FVC relative to the FEV(1) suggests the development of a re strictive process in this group of patients.