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Pretransplant Pulmonary Evaluation of the Blood and Marrow Transplant Recipient

Bekele Afessa, MD, FCCP
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Affiliations: Rochester, MN
 ,  Dr. Afessa is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine.

Correspondence to: Bekele Afessa, MD, FCCP, 200 First St SW, Mayo Clinic, Rochester, MN 55905; e-mail: Afessa.Bekele@mayo.edu



Chest. 2005;128(1):8-10. doi:10.1378/chest.128.1.8
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Thousands of patients undergo blood and marrow transplantation (BMT) each year, mainly for malignant hematologic disorders.12 Their underlying diseases, intensive chemotherapy, radiation therapy, and conditioning regimen, with or without total body irradiation, are among the factors that place BMT recipients at high risk for posttransplant pulmonary complications. The development of graft-vs-host disease (GVHD) and the frequent use of immunosuppressant therapy increase this risk to an even higher level in allogeneic BMT recipients.3 As a result, pulmonary complications develop in 30 to 60% of BMT recipients.46 With the recent developments and wide use of effective prophylaxis against certain infections, the spectrum of pulmonary complications is changing.78 The pretransplant pulmonary evaluation should focus on identifying and modifying the factors that increase the risk for posttransplant complications.

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