PULMONARY-FUNCTION CHANGES 100 DAYS AND ONE-YEAR AFTER BONE-MARROW TRANSPLANTATION

The pulmonary function of patients receiving autologous or allogeneic bone marrow transplantation (BMT) was studied before, 100 days after a nd 1 year after BMT. The 117 patients studied before transplantation s howed a slight reduction in average total lung capacity (TLC) and tran sfer coefficient (KCO). These reductions were related to haematologica l disease, previous pulmonary disease or irradiation, or use of toxic lung chemotherapy. Studies 100 days after BMT showed TLC and KCO decre ases of 5% and 8%, respectively. These decreases were related to diffe rent factors in autologous and allogeneic BMT. The results were influe nced by previous pulmonary status in autologous BMT patients and the o ccurrence of GVHD in allogeneic BMT patients. Seventy patients underwe nt pulmonary function testing 1 year after BMT. The decrease in TLC va lues was greater in autologous BMT than in allogeneic BMT patients (10 7 +/- 3% to 100 +/- 3% versus 113 +/- 3% to 112 +/- 2%, respectively) although TLC remained normal in both groups. KCO values dropped signif icantly in both populations. Relapse of the initial disease was an imp ortant factor impairing lung function in the autologous group. TLC and KCO changes were strongly related to mortality in both groups. These results emphasise the need for frequent pulmonary function tests after BMT to detect and quantify lung function changes.