Utility of routine pulmonary function test after autologous hematopoietic cell transplantation in lymphoma

Abstract

This study aims to evaluate the predictive value of routine pulmonary function testing (PFT) at the 12-month mark post-autologous hematopoietic cell transplant (AHCT) in identifying clinically significant lung disease in lymphoma survivors. In 247 patients, 173 (70%) received BEAM (carmustine, etoposide, cytarabine, melphalan), and 49 (20%) received TBC (thiotepa, busulfan, cyclophosphamide) conditioning regimens. Abnormal baseline PFT was noted in 149 patients (60%). Thirty-four patients had a significant decline (reduction of >/= 20% in DLCO or FEV1 or FVC) in post-AHCT PFT, with the highest incidence in the CNS lymphoma group (39%). The incidence of clinically significant lung disease post-transplant was low at 2% and there was no association between abnormal pre- and 1-year post-transplant PFTs with the development of clinical lung disease. While this study illustrates the impact of treatment regimens on PFT changes, it did not demonstrate a predictive value of scheduled PFTs in identifying clinically significant post-AHCT lung disease.

Keywords:

• Pulmonary function test
• pFT
• autologous
• transplant
• lymphoma

Author contributions

P.B.D., S.K., A.G., and A.A.J. substantially contributed to conception and design of the study; P.B.D., S.K., J.F., S.M.D., J.D.R., S.A.C., A.G., and A.A.J. helped acquire, analyze, and interpret data; P.B.D., S.K., J.F., S.M.D., J.D.R., S.A.C., O.B.L., M.J.M., C.H.M., M-A.P., G.S., C.S.S., S.A.G., A.G., and A.A.J. helped draft the manuscript and critically reviewed and revised it; All authors approved the final version of the manuscript.

Disclosure statement

The authors declare no conflicts of interest related to the presented work. This study was supported in part by National Institutes of Health Grant P01 CA23766 and National Cancer Institute Cancer Center Support Grant P30 CA008748. Outside the scope of this work, P.B.D., S.K., J.F., S.M.D, J.D.R., S.A.C., A.G., and A.A.J. have no disclosures. O.B.L. served on advisory board for Morphosys, Inc. M.J.M has received honoraria from Genentech, Roche, ADC Therapeutics, AstraZenecam BMS, Bayer, Pharmacyclics, Janssen, SeaGen, Immunovaccine Technologies, Takeda, and Epizyme, has participated in a consulting or advisory role for Genentech, Bayer, Merck, Juno Therapeutics, Roche, Teva, SeaGen, Takeda and Epizyme, and has received research funding from Genentech, Roche, IGM Biosciences, Bayer, Pharmacyclis, Janssen, SeaGen, Immunovaccine Technologies. M-A.P. reports honoraria from Adicet, Allogene, Allovir, Caribou Biosciences, Celgene, Bristol-Myers Squibb, Equilium, Exevir, ImmPACT Bio, Incyte, Karyopharm, Kite/Gilead, Merck, Miltenyi Biotec, MorphoSys, Nektar Therapeutics, Novartis, Omeros, OrcaBio, Syncopation, VectivBio AG, and Vor Biopharma. He serves on DSMBs for Cidara Therapeutics, Medigene, and Sellas Life Sciences, and the scientific advisory board of NexImmune. He has ownership interests in NexImmune, Omeros and OrcaBio. He has received institutional research support for clinical trials from Allogene, Incyte, Kite/Gilead, Miltenyi Biotec, Nektar Therapeutics, and Novartis. G.S. received research funding from Janssen, Amgen, BMS, Beyond Spring and serves as a DSMB member of Arcellx. C.S.S has served as a paid consultant for Kite/a Gilead Company, Celgene/BMS, Gamida Cell, Karyopharm Therapeutics, Ono Pharmaceuticals, MorphoSys, CSL Behring, Syncopation Life Sciences, CRISPR Therapeutics and GSK. He has received research funds for clinical trials from: Juno Therapeutics, Celgene/BMS, Bristol-Myers Squibb, Precision Biosciences, Actinium Pharmaceuticals, Sanofi-Genzyme and NKARTA. S.A.G. served as a consultant for and received honoraria and research funding from Celgene and Novartis; served as a consultant for and received research funding from Amgen, Actinuum, Miltenyi Biotech, Johnson & Johnson, and Spectrum Pharma; served as a consultant for and received honoraria from Jazz Pharmaceuticals and Omeros; received research funding from Takeda; and served as a consultant for Kite Pharma. The remaining authors declare no competing financial interests.

Additional information

Funding

This study was supported in part by National Institutes of Health Grant P01 CA23766 and National Cancer Institute Cancer Center Grant P30 CA008748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.