Pulmonary permeability in hematologic malignancies. Effects of the disease and cytotoxic agents.

Pulmonary permeability was assessed using the technique of DTPA aerosol transfer in untreated patients with chronic lymphocytic leukemia (CLL) and in patients with a variety of hematologic malignancies that had all been treated with alkylating agents. Two findings emerged: In the untreated CLL patients, the permeability of the upper and middle lung regions was reduced. This may be due to diffuse infiltration by the CLL; and Treatment with cytotoxic agents increased epithelial permeability in both middle and lower lung regions. Further prospective studies are required to determine the cause of the long T50 values in untreated CLL and to confirm that the DTPA transfer test is a sensitive indicator of the damage which eventually leads to pulmonary fibrosis.