Abstract:
BACKGROUND:The purpose of this study was to determine the prevalence of pulmonary dysfunction in pediatric hematopoietic cell transplant (HCT) survivors and to identify associated risk factors. PROCEDURE:In a cross-sectional study, patients surviving at least 5 years after pediatric HCT were requested to undergo pulmonary function testing (PFT). Risk factors for restrictive lung disease (RLD) and obstructive lung disease (OLD) were analyzed using multivariate analysis. RESULTS:Among 472 patients contacted, 260 (55%) participated and 215 were selected for analysis. These patients were transplanted at a median age of 8.3 (0.3-18.0) years; 175 for hematologic malignancies and 40 for non-malignant diseases. The preparative regimens for 133 patients included fractionated TBI (FTBI), 29 single-fraction TBI (SFTBI), and 53 non-TBI regimens. PFT was performed at a median of 10 (5.0-27.5) years after HCT. Forty percent of patients had either RLD or OLD (28% RLD, 9% OLD, 3% mixed RLD/OLD) and at least 15% had an isolated low-DLCO. Moderate-to-severe impairment was present in 45% of patients with RLD or OLD. In multivariate analysis, risk factors associated with RLD included transplant regimen, transplant diagnosis, scleroderma/contracture, and donor relation. Patients treated with SFTBI had the highest risk of RLD. Risk factors for OLD included chronic graft-versus-host disease, transplant regimen, and time after HCT. Patients surviving 20 or more years after HCT had the highest risk of OLD. CONCLUSIONS:Fifty-five percent of long-term pediatric HCT survivors had pulmonary dysfunction. These findings stress the need for long-term follow-up to detect pulmonary dysfunction.
journal_name
Pediatr Blood Cancerjournal_title
Pediatric blood & cancerauthors
Hoffmeister PA,Madtes DK,Storer BE,Sanders JEdoi
10.1002/pbc.20531keywords:
subject
Has Abstractpub_date
2006-10-15 00:00:00pages
594-606issue
5eissn
1545-5009issn
1545-5017journal_volume
47pub_type
杂志文章abstract::Most publications report the adverse (negative) health issues in childhood cancer survivors. Presenting information to the newly diagnosed patient in a positive manner is advocated, while noting that recurrence is the most likely adverse event. Re-analysis of population-based studies on life-threatening toxicities fro...
journal_title:Pediatric blood & cancer
pub_type: 杂志文章,评审
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journal_title:Pediatric blood & cancer
pub_type: 更正并重新发布的文章,杂志文章
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journal_title:Pediatric blood & cancer
pub_type: 临床试验,杂志文章
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章,多中心研究
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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更新日期:2015-02-01 00:00:00
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章,随机对照试验
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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doi:10.1002/pbc.24799
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journal_title:Pediatric blood & cancer
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doi:10.1002/pbc.21480
更新日期:2008-06-01 00:00:00
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journal_title:Pediatric blood & cancer
pub_type: 临床试验,杂志文章
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journal_title:Pediatric blood & cancer
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doi:10.1002/pbc.24271
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章,多中心研究
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journal_title:Pediatric blood & cancer
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章
doi:10.1002/pbc.22865
更新日期:2011-07-01 00:00:00
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章,评审
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journal_title:Pediatric blood & cancer
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章,实务指引,评审
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更新日期:2011-10-01 00:00:00
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journal_title:Pediatric blood & cancer
pub_type: 杂志文章
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更新日期:2017-07-01 00:00:00
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journal_title:Pediatric blood & cancer
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