Document Detail


Long-term survival from respiratory failure after marrow transplantation for malignancy.
MedLine Citation:
PMID:  1546828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Respiratory failure was measured as the institution of assisted mechanical ventilation for hypoxemic (oxygenation) or hypercarbic (ventilatory) failure after marrow transplantation. There were 348 (23%) marrow recipients who required mechanical ventilation for an average of 8 days (median, 5; range, 1 to 45). The average onset of mechanical ventilation was 39 days (median, 22; range, 0 to 172) after transplantation. Factors previously found to be associated with mechanical ventilation were tested in a Cox proportional hazards model. Older age, active malignancy at time of transplantation, and donor-recipient marrow HLA-non-identity were independent risks for assisted mechanical ventilation after marrow transplantation. Twenty-one percent (n = 72) of the marrow recipients receiving assisted mechanical ventilation for respiratory failure were extubated. Four percent (n = 15) were discharged from the hospital, and 3% (n = 10) survived 6 months after transplantation. All of these survivors were physically functional. Three had mild chronic respiratory symptoms and restrictive or obstructive airflow defects 1 yr after transplantation. Respiratory failure requiring assisted mechanical ventilatory support occurs in 23% of marrow recipients and is associated with functional survival at 6 months in 3%. Older age, active malignancy at time of transplantation, and donor-recipient marrow HLA-non-identity are risk factors for subsequent respiratory failure. In view of the poor prognosis associated with respiratory failure, these factors should be considered when counseling patients and families regarding this mode of treatment.
Authors:
S W Crawford; F B Petersen
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  145     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-04-10     Completed Date:  1992-04-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  510-4     Citation Subset:  AIM; IM    
Affiliation:
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Marrow Transplantation / mortality*,  statistics & numerical data
Child
Child, Preschool
Humans
Infant
Middle Aged
Neoplasms / mortality,  therapy*
Proportional Hazards Models
Respiration, Artificial / statistics & numerical data
Respiratory Function Tests
Respiratory Insufficiency / etiology,  mortality*,  therapy
Risk Factors
Time Factors
Grant Support
ID/Acronym/Agency:
CA-18029/CA/NCI NIH HHS; CA-47748/CA/NCI NIH HHS; HL-36444/HL/NHLBI NIH HHS

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