The lung function score and its components as predictors of overall survival and chronic graft-vs-host disease after allogeneic stem cell transplantation

Croat Med J. 2016 Feb;57(1):16-28. doi: 10.3325/cmj.2016.57.16.

Abstract

Aim: To retrospectively assess if the modified lung function score (LFS) and/or its components, forced expiratory volume within the first second (FEV1) and diffusion capacity for carbon monoxide corrected for hemoglobin level (cDLCO), predict overall survival (OS) and chronic graft-vs-host-disease (cGvHD).

Methods: We evaluated 241 patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the University of Regensburg Transplant Center between June 1998 and July 2005 in relation to their LFS, FEV1 and cDLCO, before and after HSCT.

Results: Decreased OS after allo-HSCT was related to decreased pre-transplantation values of FEV1<60% (P=0.040), cDLCO<50% of predicted value (P=0.025), and LFS≥III (P=0.037). It was also related to decreased FEV1 at 3 and 12 months after HSCT (P<0.001 and P=0.001, respectively) and increased LFS at 3 and 12 months after HSCT (P=.028 and P=0.002, respectively), but not to changes of cDLCO. A higher incidence of cGvHD was related to decreased FEV1 at 6, 12, and 18 months (P=0.069, P=0.054, and P=0.009, respectively) and increased LFS at 12 months (P=0.002), but not to changes in cDLCO.

Conclusions: OS was related to both LFS and FEV1, but cGvHD had a stronger relation to FEV1 than to cDLCO or LFS. FEV1 alone offered more information on the outcome after allo-HSCT than LFS or cDLCO, suggesting limited value of LFS for the patients' assessment after allo-HSCT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carbon Dioxide / metabolism
  • Female
  • Forced Expiratory Volume*
  • Graft vs Host Disease / epidemiology*
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Period
  • Predictive Value of Tests
  • Preoperative Period
  • Pulmonary Diffusing Capacity*
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Transplantation, Homologous
  • Young Adult

Substances

  • Carbon Dioxide