The Value of Pulmonary Function Testing in Bone Marrow Transplantation

Introduction

The current guidelines from the international literature, which have been incorporated into the Bone Marrow Transplant (BMT) protocols of specialized health care facilities, recommend that pulmonary function tests (PFTs) be performed before transplantation and as a posttransplant follow-up evaluation. The general belief is that PFTs in the pretransplant period assist in establishing a reference baseline for posttransplant PFT measurements as well as identify those patients with abnormal pretransplant PFTs. Testing may be useful in expediting the diagnosis of posttransplant noninfectious pulmonary complications allowing for early intervention and the consequent increase in patient survival. However, the question remains whether there is sufficient reliable data to support and validate this practice. In this article we reviewed the publications that have assessed the use of pretransplant PFTs in bone marrow transplant patients and determined their validity and usefulness in identifying those patients who are at high risk for developing posttransplant noninfectious pulmonary complications. We conducted a PubMed search to identify all the publications that have investigated the role of pretransplant pulmonary functions tests in predicting posttransplant pulmonary complication in patients undergoing bone marrow transplant. These articles are analyzed and their significant findings were summarized below.

Abstract

INTRODUCTION

The pre- and postbone marrow transplant pulmonary functions testing are widely used as standard clinical practice. However, whether there is sufficient reliable data to support and validate this practice is not confirmed.

OBJECTIVE

In this article we will review the publications that have assessed the role of pretransplant pulmonary functions tests for bone marrow transplant patients in identifying those patients who are at high risk for developing posttransplant noninfectious pulmonary complications.

METHODS

PubMed search to identify the publications that have investigated the role of pretransplant pulmonary functions tests in predicting posttransplant pulmonary complication in patients undergoing bone marrow transplant.

RESULTS

Several small studies suggest a risk of posttransplant complications associated with pretransplant obstructive patterns.

CONCLUSION

Large randomized control trials examining pretransplant lung function are needed, including both nonmyeloablative and myeloablative conditioning regimens, to determine how pretransplant pulmonary function data can be applied clinically to reduce patient risk for significant pulmonary complications and mortality.

Keywords

pulmonary function testing, bone marrow transplant, pulmonary complications