Long-term pulmonary complications from stem cell transplantation

Medscape (4/30, Chustecka) reports on a study from the journal Cancer ( abstract ) that pediatric leukemia patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) are often cured of their leukemia, but have significant pulmonary complications as measured by pulmonary function tests.  In contrast, patients with leukemias who are not treated with HSCT and the related treatments do not show an increase in pulmonary problems notes the study's lead researcher, Hiroto Inaba, MD, PhD. Medscape adds, "The problems affecting the lungs arise from the transplant and the related treatments involved in preconditioning, which include high-dose chemotherapy and total body irradiation."  The following pulmonary function values declined significantly with time: FEV₁/FVC, forced mid-expiratory flow (FEF_25%-75%), total lung capacity (TLC), diffusion capacity corrected for hemoglobin (DLCO_corr), RV, FRC, and RV/TLC which suggests a progressive restrictive type defect.  I'm not aware of any studies looking at the radiographic or histologic lesions associated with post-alloHSCT but it bears further investigation.