We investigated pulmonary function and bronchoalveolar lavage fluid (BALF) before and after
COP-BLAM III therapy in elderly patients with
non-Hodgkin's lymphoma (NHL). The patients consisted of 8 men and 5 women, over 60 years of age, with previously untreated NHL. The PaO2 averaged 86.5 +/- 7.6 mmHg before treatment, and 69.3 +/- 9.2 mmHg
after treatment. Six Patients showed a decrease in PaO2 to less than 20 mmHg. Percent (%)
carbon monoxide diffusion capacity was 91.4 +/- 7.1% before treatment and 69.6 +/- 11.5%
after-treatment, and 8 patients showed a decrease of at least 20%, whereas there were no definite changes in percent vital capacity or the percent of forced expiratory volume in one second. After BALF collection, the total cell count was slightly increased and the lymphocyte count was also increased
after treatment, whereas there were no significant changes in neutrophil or eosinophil counts. There were no significant changes in T-cell or B-cell counts
after treatment. The CD4/CD8 was 0.51 before treatment and 1.65
after treatment in patients without pulmonary complications, showing a tendency to increase, while the low ratio before treatment, 0.24, was nearly unchanged
after treatment in those who developed
pneumonia during their course. Considerable attention should be paid to pulmonary complications. As a result of
chemotherapy, lymphocytic infiltration was observed subclinically in the lung, suggesting that changes in the local pulmonary immune system may be involved in the occurrence of pulmonary complications.