Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE)

Daniel M. Green, Liang Zhu, Mingjuan Wang, Kirsten K. Ness, Matthew J. Krasin, Nickhill H. Bhakta, M. Beth McCarville, Saumini Srinivasan, Dennis C. Stokes, Deokumar Srivastava, Rohit Ojha, Kyla Shelton, Ching Hon Pui, Gregory Armstrong, Daniel A. Mulrooney, Monika Metzger, Sheri L. Spunt, Fariba Navid, Andrew M. Davidoff, Bhaskar N. RaoLeslie L. Robison, Melissa M. Hudson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Rationale: The relationship between treatment-related impairment of pulmonary function in adult survivors of childhood cancer and subsequent physical function has not been studied. Objectives: In this prospective evaluation of 606 adult survivors of childhood cancer, we sought to determine the risk factors for, as well as the functional impact of, clinically ascertained pulmonary function impairment. Methods: We measured FEV1, FVC, total lung capacity (TLC), and single-breath diffusing capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr), expressing the results as percent predicted and lower limit of normal (LLN) values, and we also assessed functional exercise capacity (6-minute-walk distance). Lung radiation exposure was expressed as the estimated percentage of lung tissue that received at least 10 Gy (V10). Associations of clinical and treatment factors with pulmonary function measures were assessed using log-binomial regression to calculate relative risks and 95% confidence intervals. Measurements and Main Results: The participants'median age at evaluation was 34.2 years, and the median elapsed time from diagnosiswas 21.9 years.Among the sample population, 50.7%had an FEV1 percent predicted less than 80%, 47.2% had an FVC percent predicted less than 80%, 31.2% had a TLC percent predicted less than 75%, and 44.6% had DLCOcorr percent predicted less than 75%. Also, 49.0% had FEV1 less than the LLN on the basis of the Global Lung Function Initiative (GLI) criteria, and 45.4% had FVC less than LLN. Obstructive lung defects (FEV1/FVC, ,0.7) were found in 0.8%, but none had obstructive lung defects on the basis of the GLI criterion of FEV1/FVC less than the LLN. Restrictive lung defects (TLC, ,75%) were found in 31.2% of participants. V10 and elapsed time since diagnosis were associated with abnormal FEV1 and FVC based on the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria, and with abnormal FEV1 using the GLI criterion. Age at diagnosis was an additional risk factor for abnormal FVC based on the GLI criteria. Age at diagnosis and V10 were associated with abnormal TLC. Increased body mass index, V10, and elapsed time since diagnosis were risk factors for abnormal DLCOcorr. Abnormal pulmonary function tests were associated with decreased 6-minute walk distance. Conclusions: Impaired pulmonary function in adult survivors of childhood cancer is associated with decreased physical function. These patients may benefit from interventions designed to preserve and/or improve pulmonary function.

Original languageEnglish (US)
Pages (from-to)1575-1585
Number of pages11
JournalAnnals of the American Thoracic Society
Volume13
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Cohort Studies
Lung
Neoplasms
Total Lung Capacity
Therapeutics
Lung Volume Measurements
National Cancer Institute (U.S.)
Respiratory Function Tests
Carbon Monoxide
Terminology
Survivors
Reference Values
Hemoglobins
Body Mass Index
Confidence Intervals
Exercise

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE). / Green, Daniel M.; Zhu, Liang; Wang, Mingjuan; Ness, Kirsten K.; Krasin, Matthew J.; Bhakta, Nickhill H.; McCarville, M. Beth; Srinivasan, Saumini; Stokes, Dennis C.; Srivastava, Deokumar; Ojha, Rohit; Shelton, Kyla; Pui, Ching Hon; Armstrong, Gregory; Mulrooney, Daniel A.; Metzger, Monika; Spunt, Sheri L.; Navid, Fariba; Davidoff, Andrew M.; Rao, Bhaskar N.; Robison, Leslie L.; Hudson, Melissa M.

In: Annals of the American Thoracic Society, Vol. 13, No. 9, 01.09.2016, p. 1575-1585.

Research output: Contribution to journalArticle

Green, DM, Zhu, L, Wang, M, Ness, KK, Krasin, MJ, Bhakta, NH, McCarville, MB, Srinivasan, S, Stokes, DC, Srivastava, D, Ojha, R, Shelton, K, Pui, CH, Armstrong, G, Mulrooney, DA, Metzger, M, Spunt, SL, Navid, F, Davidoff, AM, Rao, BN, Robison, LL & Hudson, MM 2016, 'Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE)', Annals of the American Thoracic Society, vol. 13, no. 9, pp. 1575-1585. https://doi.org/10.1513/AnnalsATS.201601-022OC
Green, Daniel M. ; Zhu, Liang ; Wang, Mingjuan ; Ness, Kirsten K. ; Krasin, Matthew J. ; Bhakta, Nickhill H. ; McCarville, M. Beth ; Srinivasan, Saumini ; Stokes, Dennis C. ; Srivastava, Deokumar ; Ojha, Rohit ; Shelton, Kyla ; Pui, Ching Hon ; Armstrong, Gregory ; Mulrooney, Daniel A. ; Metzger, Monika ; Spunt, Sheri L. ; Navid, Fariba ; Davidoff, Andrew M. ; Rao, Bhaskar N. ; Robison, Leslie L. ; Hudson, Melissa M. / Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE). In: Annals of the American Thoracic Society. 2016 ; Vol. 13, No. 9. pp. 1575-1585.
@article{db292aacb7d24d4ba837c875e1c5ba12,
title = "Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE)",
abstract = "Rationale: The relationship between treatment-related impairment of pulmonary function in adult survivors of childhood cancer and subsequent physical function has not been studied. Objectives: In this prospective evaluation of 606 adult survivors of childhood cancer, we sought to determine the risk factors for, as well as the functional impact of, clinically ascertained pulmonary function impairment. Methods: We measured FEV1, FVC, total lung capacity (TLC), and single-breath diffusing capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr), expressing the results as percent predicted and lower limit of normal (LLN) values, and we also assessed functional exercise capacity (6-minute-walk distance). Lung radiation exposure was expressed as the estimated percentage of lung tissue that received at least 10 Gy (V10). Associations of clinical and treatment factors with pulmonary function measures were assessed using log-binomial regression to calculate relative risks and 95{\%} confidence intervals. Measurements and Main Results: The participants'median age at evaluation was 34.2 years, and the median elapsed time from diagnosiswas 21.9 years.Among the sample population, 50.7{\%}had an FEV1 percent predicted less than 80{\%}, 47.2{\%} had an FVC percent predicted less than 80{\%}, 31.2{\%} had a TLC percent predicted less than 75{\%}, and 44.6{\%} had DLCOcorr percent predicted less than 75{\%}. Also, 49.0{\%} had FEV1 less than the LLN on the basis of the Global Lung Function Initiative (GLI) criteria, and 45.4{\%} had FVC less than LLN. Obstructive lung defects (FEV1/FVC, ,0.7) were found in 0.8{\%}, but none had obstructive lung defects on the basis of the GLI criterion of FEV1/FVC less than the LLN. Restrictive lung defects (TLC, ,75{\%}) were found in 31.2{\%} of participants. V10 and elapsed time since diagnosis were associated with abnormal FEV1 and FVC based on the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria, and with abnormal FEV1 using the GLI criterion. Age at diagnosis was an additional risk factor for abnormal FVC based on the GLI criteria. Age at diagnosis and V10 were associated with abnormal TLC. Increased body mass index, V10, and elapsed time since diagnosis were risk factors for abnormal DLCOcorr. Abnormal pulmonary function tests were associated with decreased 6-minute walk distance. Conclusions: Impaired pulmonary function in adult survivors of childhood cancer is associated with decreased physical function. These patients may benefit from interventions designed to preserve and/or improve pulmonary function.",
author = "Green, {Daniel M.} and Liang Zhu and Mingjuan Wang and Ness, {Kirsten K.} and Krasin, {Matthew J.} and Bhakta, {Nickhill H.} and McCarville, {M. Beth} and Saumini Srinivasan and Stokes, {Dennis C.} and Deokumar Srivastava and Rohit Ojha and Kyla Shelton and Pui, {Ching Hon} and Gregory Armstrong and Mulrooney, {Daniel A.} and Monika Metzger and Spunt, {Sheri L.} and Fariba Navid and Davidoff, {Andrew M.} and Rao, {Bhaskar N.} and Robison, {Leslie L.} and Hudson, {Melissa M.}",
year = "2016",
month = "9",
day = "1",
doi = "10.1513/AnnalsATS.201601-022OC",
language = "English (US)",
volume = "13",
pages = "1575--1585",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "9",

}

TY - JOUR

T1 - Pulmonary function after treatment for childhood cancer a report from the st. jude lifetime cohort study (SJLIFE)

AU - Green, Daniel M.

AU - Zhu, Liang

AU - Wang, Mingjuan

AU - Ness, Kirsten K.

AU - Krasin, Matthew J.

AU - Bhakta, Nickhill H.

AU - McCarville, M. Beth

AU - Srinivasan, Saumini

AU - Stokes, Dennis C.

AU - Srivastava, Deokumar

AU - Ojha, Rohit

AU - Shelton, Kyla

AU - Pui, Ching Hon

AU - Armstrong, Gregory

AU - Mulrooney, Daniel A.

AU - Metzger, Monika

AU - Spunt, Sheri L.

AU - Navid, Fariba

AU - Davidoff, Andrew M.

AU - Rao, Bhaskar N.

AU - Robison, Leslie L.

AU - Hudson, Melissa M.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Rationale: The relationship between treatment-related impairment of pulmonary function in adult survivors of childhood cancer and subsequent physical function has not been studied. Objectives: In this prospective evaluation of 606 adult survivors of childhood cancer, we sought to determine the risk factors for, as well as the functional impact of, clinically ascertained pulmonary function impairment. Methods: We measured FEV1, FVC, total lung capacity (TLC), and single-breath diffusing capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr), expressing the results as percent predicted and lower limit of normal (LLN) values, and we also assessed functional exercise capacity (6-minute-walk distance). Lung radiation exposure was expressed as the estimated percentage of lung tissue that received at least 10 Gy (V10). Associations of clinical and treatment factors with pulmonary function measures were assessed using log-binomial regression to calculate relative risks and 95% confidence intervals. Measurements and Main Results: The participants'median age at evaluation was 34.2 years, and the median elapsed time from diagnosiswas 21.9 years.Among the sample population, 50.7%had an FEV1 percent predicted less than 80%, 47.2% had an FVC percent predicted less than 80%, 31.2% had a TLC percent predicted less than 75%, and 44.6% had DLCOcorr percent predicted less than 75%. Also, 49.0% had FEV1 less than the LLN on the basis of the Global Lung Function Initiative (GLI) criteria, and 45.4% had FVC less than LLN. Obstructive lung defects (FEV1/FVC, ,0.7) were found in 0.8%, but none had obstructive lung defects on the basis of the GLI criterion of FEV1/FVC less than the LLN. Restrictive lung defects (TLC, ,75%) were found in 31.2% of participants. V10 and elapsed time since diagnosis were associated with abnormal FEV1 and FVC based on the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria, and with abnormal FEV1 using the GLI criterion. Age at diagnosis was an additional risk factor for abnormal FVC based on the GLI criteria. Age at diagnosis and V10 were associated with abnormal TLC. Increased body mass index, V10, and elapsed time since diagnosis were risk factors for abnormal DLCOcorr. Abnormal pulmonary function tests were associated with decreased 6-minute walk distance. Conclusions: Impaired pulmonary function in adult survivors of childhood cancer is associated with decreased physical function. These patients may benefit from interventions designed to preserve and/or improve pulmonary function.

AB - Rationale: The relationship between treatment-related impairment of pulmonary function in adult survivors of childhood cancer and subsequent physical function has not been studied. Objectives: In this prospective evaluation of 606 adult survivors of childhood cancer, we sought to determine the risk factors for, as well as the functional impact of, clinically ascertained pulmonary function impairment. Methods: We measured FEV1, FVC, total lung capacity (TLC), and single-breath diffusing capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr), expressing the results as percent predicted and lower limit of normal (LLN) values, and we also assessed functional exercise capacity (6-minute-walk distance). Lung radiation exposure was expressed as the estimated percentage of lung tissue that received at least 10 Gy (V10). Associations of clinical and treatment factors with pulmonary function measures were assessed using log-binomial regression to calculate relative risks and 95% confidence intervals. Measurements and Main Results: The participants'median age at evaluation was 34.2 years, and the median elapsed time from diagnosiswas 21.9 years.Among the sample population, 50.7%had an FEV1 percent predicted less than 80%, 47.2% had an FVC percent predicted less than 80%, 31.2% had a TLC percent predicted less than 75%, and 44.6% had DLCOcorr percent predicted less than 75%. Also, 49.0% had FEV1 less than the LLN on the basis of the Global Lung Function Initiative (GLI) criteria, and 45.4% had FVC less than LLN. Obstructive lung defects (FEV1/FVC, ,0.7) were found in 0.8%, but none had obstructive lung defects on the basis of the GLI criterion of FEV1/FVC less than the LLN. Restrictive lung defects (TLC, ,75%) were found in 31.2% of participants. V10 and elapsed time since diagnosis were associated with abnormal FEV1 and FVC based on the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 criteria, and with abnormal FEV1 using the GLI criterion. Age at diagnosis was an additional risk factor for abnormal FVC based on the GLI criteria. Age at diagnosis and V10 were associated with abnormal TLC. Increased body mass index, V10, and elapsed time since diagnosis were risk factors for abnormal DLCOcorr. Abnormal pulmonary function tests were associated with decreased 6-minute walk distance. Conclusions: Impaired pulmonary function in adult survivors of childhood cancer is associated with decreased physical function. These patients may benefit from interventions designed to preserve and/or improve pulmonary function.

UR - http://www.scopus.com/inward/record.url?scp=84989325836&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84989325836&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.201601-022OC

DO - 10.1513/AnnalsATS.201601-022OC

M3 - Article

C2 - 27391297

AN - SCOPUS:84989325836

VL - 13

SP - 1575

EP - 1585

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 9

ER -