Yazarlar : Tran J, Norder E, Diaz P, Phillips GS, Elder P, Devine SM, Wood KL.

Yayın : Biol Blood Marrow Transplant.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22300617

Konu : Kemik İliği Nakli

Literatür İçeriği :  

Abstract

Bronchiolitis obliterans syndrome (BOS) is a progressive, insidious lung disease affecting allogeneic hematopoietic stem cell transplant (HSCT) recipients. Unfortunately, there is no standardized approach for treatment of BOS in post HSCT patients. Pulmonary rehabilitation is a standard treatment in emphysema, an irreversible obstructive lung disease secondary to tobacco abuse. The National Emphysema Treatment Trial (NETT) demonstrated improved exercise tolerance, decrease dyspnea, and increase of quality of life in patients with severe emphysema after pulmonary rehabilitation. We hypothesized that pulmonary rehabilitation may benefit patients with BOS. Patients with BOS were identified retrospectively from January 2005 to the present. Patients who enrolled in pulmonary rehabilitation were included in the study. We obtained summaries via chart review of each patient's progress after pulmonary rehabilitation enrollment from their respective rehabilitation centers. Six minute walk distances, spirometry, and pulmonary symptoms were compared before and after the completion of pulmonary rehabilitation. We identified 11 patients with BOS documented from their pulmonologist's clinical notes that were enrolled into pulmonary rehabilitation. Ten of the 11 patients completed pulmonary rehabilitation. All patients had improvement in their 6 minute walk distances after the completion of pulmonary rehabilitation with an average improvement in distance of 307 feet (p value = 0.005). Six of the 10 patients completed a Short Form-36 questionnaires prior to and after rehab. There was a significant improvement in the physical functioning score (p value =.041). Pulmonary rehabilitation appears to improve 6 minute walk distance, subjective symptoms of dyspnea and exercise tolerance in patients with BOS. This may be an important adjunctive therapy for a debilitating disease with limited treatment options.

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