Risk factors for airflow obstruction in recipients of bone marrow transplants

Ann Intern Med. 1987 Nov;107(5):648-56. doi: 10.7326/0003-4819-107-5-648.


Obstructive lung disease is a complication of bone marrow transplantation. To identify risk factors we analyzed pulmonary function tests of 281 adult patients 1 year after marrow transplantation. The forced expiratory volume at 1 second divided by the forced vital capacity (FEV1/FVC) was used to measure airflow rates. Factors associated with a lower year-1 FEV1/FVC (%) included increased age (p less than 0.0001), male gender (p = 0.02), cigarette smoking (p = 0.01), lower FEV1/FVC before transplantation (p less than 0.0001), HLA-nonidentical grafts (p = 0.001), chronic graft-versus-host disease (p = 0.0002), and immunosuppressive therapy with methotrexate (p = 0.01). There was no significant association between the year-1 FEV1/FVC and underlying disease, dose of conditioning irradiation, or development of acute graft-versus-host disease. Linear multivariate regression analysis, after controlling for the FEV1/FVC before transplantation, shows both chronic graft-versus-host disease and administration of methotrexate independently associated with decrements in the year-1 FEV1/FVC. The combined occurrence of chronic graft-versus-host disease and methotrexate also was strongly associated with decreases in the year-1 FEV1/FVC, indicating an interaction of these risk factors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Bone Marrow Transplantation*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Graft vs Host Disease / physiopathology
  • Humans
  • Lung Diseases, Obstructive / etiology*
  • Male
  • Methotrexate / adverse effects
  • Postoperative Complications / etiology*
  • Risk Factors
  • Vital Capacity


  • Methotrexate