STUDY OBJECTIVE: To determine the value of pulmonary function tests (PFTs) in predicting the development of human cytomegalovirus (CMV)-associated interstitial pneumonia (IP) in allogeneic bone marrow transplant (BMT) recipients. DESIGN: Nonrandomized, prospective, open-trial study. SETTING: Tertiary referral medical center. PATIENTS: 66 evaluable CMV-seropositive patients with hematologic malignancies who were undergoing allogeneic BMT. INTERVENTION: FEV1, FVC, FEV1/FVC, TLC, Dcoc/VA, PaO2, and P(A-a)O2 were measured on days -13, +33, and +44 following BMT. CMV-IP was diagnosed when typical roentgenographic findings developed with confirmatory positive bronchoalveolar lavage (BAL) using standard cytologic and/or rapid culture techniques. MEASUREMENT AND MAIN RESULTS: Univariate logistic regression analysis to predict the development of CMV-IP revealed significant associations with the day -13 and +33 percent predicted FEV1, FVC, and TLC (p < 0.01) but no associations with other PFT parameters or with changes in these parameters. Stepwise logistic regression analysis demonstrated that only BAL positivity for CMV (odds ratio 14.8; p = 0.0002) and day -13 percent predicted FEV1 (odds ratio 0.92; p = 0.0004) were significant independent predictors of CMV-IP. CONCLUSION: Pretransplant lung function is a previously unrecognized strong predictor and risk factor for the subsequent development of CMV-IP in BMT recipients.
STUDY OBJECTIVE: To determine the value of pulmonary function tests (PFTs) in predicting the development of human cytomegalovirus (CMV)-associated interstitial pneumonia (IP) in allogeneic bone marrow transplant (BMT) recipients. DESIGN: Nonrandomized, prospective, open-trial study. SETTING: Tertiary referral medical center. PATIENTS: 66 evaluable CMV-seropositive patients with hematologic malignancies who were undergoing allogeneic BMT. INTERVENTION: FEV1, FVC, FEV1/FVC, TLC, Dcoc/VA, PaO2, and P(A-a)O2 were measured on days -13, +33, and +44 following BMT. CMV-IP was diagnosed when typical roentgenographic findings developed with confirmatory positive bronchoalveolar lavage (BAL) using standard cytologic and/or rapid culture techniques. MEASUREMENT AND MAIN RESULTS: Univariate logistic regression analysis to predict the development of CMV-IP revealed significant associations with the day -13 and +33 percent predicted FEV1, FVC, and TLC (p < 0.01) but no associations with other PFT parameters or with changes in these parameters. Stepwise logistic regression analysis demonstrated that only BAL positivity for CMV (odds ratio 14.8; p = 0.0002) and day -13 percent predicted FEV1 (odds ratio 0.92; p = 0.0004) were significant independent predictors of CMV-IP. CONCLUSION: Pretransplant lung function is a previously unrecognized strong predictor and risk factor for the subsequent development of CMV-IP in BMT recipients.
Authors: Tanyalak Parimon; David K Madtes; David H Au; Joan G Clark; Jason W Chien Journal: Am J Respir Crit Care Med Date: 2005-05-13 Impact factor: 21.405
Authors: Mohamed L Sorror; Sergio Giralt; Brenda M Sandmaier; Marcos De Lima; Munir Shahjahan; David G Maloney; H Joachim Deeg; Frederick R Appelbaum; Barry Storer; Rainer Storb Journal: Blood Date: 2007-09-14 Impact factor: 22.113
Authors: Alba Ramirez-Sarmiento; Mauricio Orozco-Levi; Eric C Walter; Margaret A Au; Jason W Chien Journal: Biol Blood Marrow Transplant Date: 2009-09-23 Impact factor: 5.742