Cardiopulmonary function and autologous bone marrow transplantation: Results and predictive value for respiratory failure and mortality

B. Jain, A. A. Floreani, J. R. Anderson, J. M. Vose, R. A. Robbins, S. I. Rennard, J. H. Sisson

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Cardiopulmonary complications are a major cause of morbidity and mortality in patients undergoing high-dose therapy with stem cell transplant support. Since exercise tolerance testing (ETT) assesses the cardiopulmonary reserve of an individual, we hypothesized that ETT performed prior to transplant would predict respiratory failure and mortality and would be a superior predictor over resting cardiopulmonary function tests. We performed a retrospective study of 191 lymphoma patients who underwent ETT prior to transplant between 1 June 1990 and 31 December 1992 and compared the results of ETT, with resting pulmonary function tests (PFT) and resting cardiac ejection fraction (EF). ETT revealed that cardiac, pulmonary and combined cardiopulmonary limitation were observed in 31, 20 and 16% of the patients, respectively, with a gas diffusion-type limitation being the most common exercise limitation. Resting PFT were abnormal in 58% of patients with a diffusion defect being the most common abnormality. Low EF was observed in 6.8% of patients. Twelve patients eventually required mechanical ventilation post-transplant with only the resting diffusion PFT predictive of this complication. There were five early deaths that were attributable to respiratory failure and neither resting nor ETT studies were predictive of these deaths. ETT and EF performed prior to transplant in lymphoma patients undergoing autologous transplant do not predict for either respiratory failure or short-term mortality. Our findings may be due to the rather low incidence of respiratory failure (6.3%) and low early mortality from cardiopulmonary complications (2.6%) seen in our patient population.

Original languageEnglish (US)
Pages (from-to)561-568
Number of pages8
JournalBone marrow transplantation
Volume17
Issue number4
StatePublished - Apr 1996

Keywords

  • Bone marrow transplantation
  • Exercise tolerance test
  • Pulmonary function test
  • Pulmonary toxicity
  • Respiratory failure

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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