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    Effects of High Vs. Reduced‐Dose Melphalan For Autologous Bone Marrow Transplantation in Multiple Myeloma On Pulmonary Function: A Longitudinal Study

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    Author
    Nikolich‐Zugich, Tijana
    Affiliation
    The University of Arizona College of Medicine - Phoenix
    Issue Date
    2017-05-12
    Keywords
    Hematopoietic Stem Cell Transplants
    Bone Marrow Transplants (BMT)
    Dose Reduction
    Chemotherapy
    MeSH Subjects
    Bone Marrow Transplantation
    Multiple Myeloma
    Pulmonary Function Tests
    Longitudinal Studies
    Drug Therapy
    Respiratory Function Tests
    Mentor
    Knox, Kenneth
    
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    Other Titles
    High Vs. Reduced-Dose Melphalan for Auto-BMT in Multiple Myeloma: A Longitudinal Study on Pulmonary Function
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Collection Information
    This item is part of the College of Medicine - Phoenix Scholarly Projects 2017 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.
    Publisher
    The University of Arizona.
    Abstract
    Bone marrow transplants (BMT, also hematopoietic stem cell transplants or HSCT/SCT) are one of the greatest medical achievements of the 20th century. They offer a treatment for a host of malignant and nonmalignant hematopoietic disorders, genetic diseases and solid tumors that could otherwise be fatal. Studies have found that 60% of patients undergoing BMT develop pulmonary complications (PC), and 1/3 of those require intensive care after transplantation. Despite the potential pneumotoxicity of induction agents, to date there have been no longitudinal studies following pulmonary function in this high‐risk patient population. This study reviewed patient who underwent autogeneic bone marrow transplant for multiple myeloma at Banner University Medical Center – Tucson (formerly University of Arizona Health Network) from January 1, 2003 through December 31, 2013. Pretransplant evaluatin and pulmonary function testing data were obtained and stratified between high dose (standard) Melphalan (200 mg/ms2) and reduced dose (140 mg/ms2). Statistically significant differences were present between the 2 groups at baseline for DLCO but disappeared at 6 and 12‐month followup, while a statistically significant difference for FEV1/FVC ratio was seen at baseline and 6 months but disappeared at 12‐month follow‐up. There were no statistically significant differences seen with FEV1 between the two groups. Given there is no difference in mortality and relapse outcomes between the groups, the standard of care dosing for Melphalan is not associated with an increase in pulmonary morbidity.
    Description
    A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
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    Scholarly Projects 2017

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