Late Pulmonary Complications After Hematopoietic Stem Cell Transplantation
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Karen L. Wood, MD
Medical Director of Pulmonary Rehabilitation, McConnell Heart Health Center, and Auxiliary Associate Professor of Medicine, The Ohio State University Wexner Medical Center, Division of Pulmonary, Critical Care and Sleep Medicine, Columbus, OH

Vincent G. Esguerra, MD
Assistant Clinical Professor of Medicine, Division of Pulmonary
and Critical Care Medicine, The Ohio State University Wexner Medical Center, Columbus, OH

Question 1 of 5

A 45-year-old man presents to clinic with a 1-month history of progressive dyspnea on exertion. His past medical history is notable for allogenic hematopoietic cell transplant (HSCT) 9 months ago for acute myeloid leukemia. Vital signs are stable, and the patient is nontoxic appearing. He has mild inspiratory bibasilar wheezing. Complete blood count (CBC) and chemistries are unremarkable. Chest radiograph shows hyperinflation, and routine bacterial sputum cultures are negative. Chest computed tomography (CT) shows significant air trapping and a presumptive diagnosis of bronchiolitis obliterans syndrome (BOS) is made.

What changes would you expect to see on this patient’s pulmonary function testing?

Decreased forced expiratory volume in 1 second (FEV1)/vital capacity (VC) ratio

Decrease in residual volume

Increased diffusing capacity of the lungs for carbon monoxide (DLCO)

Increased FEV1

Hospital Physician: Hematology/Oncology. 2018 March;13(2)

This quiz is not accredited for CME.

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