Scientific Publications Database

Article Title: Are We Choosing Wisely With Autologous Hematopoietic Cell Transplantation Screening? The Utility of Pulmonary Function Testing Prior to Autologous Hematopoietic Cell Transplantation
Authors: Li, Tony; Mallick, Ranjeeta; McCurdy, Arleigh; Mulpuru, Sunita; Huebsch, Lothar; Bredeson, Chris; Allan, David; Kekre, Natasha
Journal: CLINICAL LYMPHOMA MYELOMA & LEUKEMIA Volume 19 Issue 2
Date of Publication:2019
Abstract:
This study explored the utility of pre-autologous hematopoietic cell transplantation pulmonary function tests (PFTs) on predicting posttransplant clinical outcomes. Charts from patient who underwent autologous hematopoietic cell transplantation at The Ottawa Hospital between 2010 and 2012 were reviewed (n =172). PFT results, incidence of intensive care unit admission, Seattle Criteria for pulmonary toxicities, and transplantrelated mortality were retrieved. Abnormal PFT did not predict for an increased risk of pulmonary toxicity, intensive care unit admission, or transplant-related mortality at our center.Introduction: Despite the risk of morbidity and mortality associated with autologous hematopoietic cell transplantation (ASCT), there are no clear guidelines as to how to screen for these risks. This study sought to determine the utility of pulmonary function tests (PFTs) prior to ASCT on predicting posttransplant clinical outcomes. Patients and Methods: Patients undergoing ASCT between 2010 and 2012 at the Ottawa Hospital (n = 172) were reviewed. PFT results prior to ASCT were retrieved. The primary outcomes were incidence of intensive care unit (ICU) admission, Seattle Criteria for pulmonary toxicities, and transplant-related mortality (TRM). Results: PFTs were performed for 91 (53%) patients prior to ASCT. There were more smokers in the PFT cohort than the non-PFT cohort (41.8% vs. 19.8%, respectively; P <.0001). Pulmonary toxicity as measured by the Seattle Criteria did not correlate with PFT results (normal vs. abnormal, 8.1% and 6.1%, respectively; P = 1.00). There were no differences in incidence of ICU admission by PFT result (normal vs. abnormal, 2.7% vs. 8.2%, respectively; P =.61) and no difference in TRM by PFT result (normal vs. abnormal, 0% vs. 2.0%, respectively; P = 1.00). Conclusion: Despite testing patients deemed higher risk for pulmonary toxicity, abnormal PFTs did not predict for an increased risk of pulmonary toxicity, ICU admission, or TRM at our center. (C) 2018 Elsevier Inc. All rights reserved.