One of the first patients I cared for at Fred Hutch was a women in her early twenties who’d had a blood stem cell transplant. The procedure cured her leukemia, but she went on to develop bronchiolitis obliterans syndrome (BOS). It’s a rare post-transplant complication that causes scar tissue to build up in the lungs, narrowing or blocking the airway. This condition kept her from going to nursing school, and although she beat the odds — living with BOS for 16 years — it eventually took her life. To go through an intense, lifesaving procedure like a transplant only to die of a lung disease is devastating. There’s a lot of potential benefit in figuring out how problems like BOS develop; my hope is that we can eliminate the incidence and severity of BOS and other cancer treatment-related lung problems. No one should have to live every day feeling like they can’t breathe.
Fred Hutch is unique in that it’s one of the few places in the country with a group like mine: pulmonologists who exclusively see patients with cancer. I work with people who have all types of disease, from melanoma to lung cancer to leukemias. A large part of my clinical practice is caring for patients experiencing respiratory problems after a blood stem cell transplant. It can be really frustrating for someone to bounce back from such a rigorous procedure and then all of a sudden have difficulty breathing. I think it’s important to share the facts — what we know and what we don’t know — and offer hope. Many people live quite well for decades with some level of lung dysfunction, and we are starting to recognize post-transplant complications like BOS earlier and earlier. I collaborate closely with the Long-term Follow-up Program team, infectious disease experts, oncologists and other specialists to help address lung-related issues.
Area of clinical practice
High risk prevention
Respiratory problems from cancer and treatment, lung cancer early detection
I am a pulmonary critical care specialist who treats patients with respiratory problems related to cancer or cancer treatment. At Fred Hutch, I serve as the medical director of the pulmonary outpatient consult service and I provide care through the Lung Cancer Early Detection and Prevention Clinic. I am also an attending physician in the intensive care unit at UW Medical Center-Montlake.
My research is focused on improving outcomes for patients who experience lung complications following a stem cell transplant. A primary area of interest is bronchiolitis obliterans syndrome (BOS); my goal is to improve the prevention and early detection of this disease. I am also involved in multicenter national trials testing new treatments for BOS and other transplant-related lung conditions. My publications include several scientific, peer-reviewed articles about BOS and book chapters about pulmonary disease.
University of California, San Francisco
Yale University School of Medicine, Internal Medicine
Yale University School of Medicine, Pulmonary and Critical Care Medicine
Critical Care Medicine, 2009; Pulmonary Disease, 2007; Internal Medicine, 2005, American Board of Internal Medicine
Postdoctoral Fellowship, University of Pennsylvania School of Medicine
Fred Hutchinson Cancer Center Ali Al-Johani Award
Dr. Cheng received the 2020 Ali Al-Johani Award, which recognizes excellence in patient care.
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