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Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility?

Publication ,  Journal Article
Chien, JW; Sullivan, KM
Published in: Biol Blood Marrow Transplant
April 2009

Current guidelines suggest that patients with a pretransplantation diffusion capacity of the lung for carbon monoxide (DLCO) < or = 60% are not ideal candidates for hematopoietic cell transplantation (HCT); however, recent studies suggest this criterion may exclude patients who will benefit from the procedure. We conducted a study of all adult patients who underwent autologous or allogeneic HCT between 1990 and 2005, and had a DLCO < 60%, of predicted normal, to examine whether there is a lower limit for the DLCO threshold in the context of respiratory failure and nonrelapse mortality risk (NRM), and whether a comprehensive risk scoring system, such as the Pretransplant Assessment of Mortality (PAM) risk score, can more effectively risk stratify these patients with a very low pretransplantation DLCO. We found that among patients with a DLCO < or = 60% the risk of respiratory failure or NRM was not significantly different; however, the PAM score effectively risk-stratified these patients for NRM risk. There was a stepwise relationship between PAM score category and NRM risk; the highest PAM score category was associated with a 4.38-fold increase in risk (P < .001). These findings suggest that the pretransplantation DLCO should not be considered the sole eligibility criteria for allogeneic HCT.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

April 2009

Volume

15

Issue

4

Start / End Page

447 / 453

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Risk Factors
  • Retrospective Studies
  • Respiratory Insufficiency
  • Respiratory Function Tests
  • Middle Aged
  • Male
  • Immunology
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chien, J. W., & Sullivan, K. M. (2009). Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility? Biol Blood Marrow Transplant, 15(4), 447–453. https://doi.org/10.1016/j.bbmt.2008.12.509
Chien, Jason W., and Keith M. Sullivan. “Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility?Biol Blood Marrow Transplant 15, no. 4 (April 2009): 447–53. https://doi.org/10.1016/j.bbmt.2008.12.509.
Chien JW, Sullivan KM. Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility? Biol Blood Marrow Transplant. 2009 Apr;15(4):447–53.
Chien, Jason W., and Keith M. Sullivan. “Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility?Biol Blood Marrow Transplant, vol. 15, no. 4, Apr. 2009, pp. 447–53. Pubmed, doi:10.1016/j.bbmt.2008.12.509.
Chien JW, Sullivan KM. Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility? Biol Blood Marrow Transplant. 2009 Apr;15(4):447–453.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

April 2009

Volume

15

Issue

4

Start / End Page

447 / 453

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Risk Factors
  • Retrospective Studies
  • Respiratory Insufficiency
  • Respiratory Function Tests
  • Middle Aged
  • Male
  • Immunology
  • Humans