PULMONARY-FUNCTION AFTER AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN CHILDREN

Forty-two children receiving bone marrow autografts were studied prosp ectively regarding acute pulmonary complications; there was no procedu re-related mortality and only one case of interstitial pneumonitis. An analysis was also made of the pulmonary function tests (PFTs) of the 27 autografted children who were disease-free and had been followed up for at least 1 year (median 4.1 years, range 1.1-7.6 years). PFTs wer e performed before and 6, 12, 24, 36 and 60 months after autologous BM T. The mean pre-transplant values of total lung capacity (TLC), vital capacity (VC) and forced expiratory volume in one second (FEV,) were c lose to predicted but 6 months after autologous BMT there was a statis tically significant decrease (11, 13 and 15% below baseline, respectiv ely) in patients receiving total body irradiation in their conditionin g regimen. There was some but not complete recovery with time. DLCO re mained low throughout the study, irrespective of the conditioning regi men. In summary, acute pulmonary complications were few and PFTs showe d only modest changes from baseline after ABMT. At the latest follow-u p no respiratory symptoms had reportedly occurred in any of the childr en and the chest radiographs were normal. Although the results are pro mising so far, long-term follow-up is necessary to evaluate the final outcome in these children.