Factors affecting the condition and prognosis of patients with late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation: a propensity score-matched study.

PURPOSE: Late-onset non-infectious pulmonary complications (LONIPCs) represent significant sequelae of hematopoietic stem cell transplantation (HSCT), contributing to elevated non-relapse mortality rates. A comprehensive understanding of systemic conditions and prognostic indicators is essential for enhancing supportive care following onset. This study aims to compare respiratory and physical function between patients with LONIPCs and healthy controls, and to identify prognostic factors that influence survival outcomes in patients with LONIPCs.

METHODS

This study included 41 LONIPCs patients admitted to Kyoto University Hospital for lung transplant evaluation. A healthy control group comprised matched living lung transplant donors. Comparisons included respiratory function tests, 6-min walk distance (6MWD), and erector spinae muscle cross-sectional area (ESMA). Multivariate Cox regression analysis was used to identify prognostic factors.

RESULTS

LONIPCs patients demonstrated significantly reduced respiratory function and 6MWD compared to healthy controls. ESMA was also significantly lower in the patient group. Multivariate Cox regression revealed that decreased knee extensor strength and reduced ESMA were significant predictors of overall survival in patients with LONIPCs.

CONCLUSION

Impairments in respiratory and physical function are evident in LONIPCs patients. Modifiable factors such as lower limb muscle strength and skeletal muscle mass, particularly ESMA, are associated with prognosis and should be prioritized in rehabilitation strategies to improve patient outcomes.