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Article: Pre-hematopoietic stem cell transplant lung function and pulmonary complications in children

TitlePre-hematopoietic stem cell transplant lung function and pulmonary complications in children
Authors
KeywordsPediatric
Pulmonary function
Post-transplant complications
Issue Date2014
Citation
Annals of the American Thoracic Society, 2014, v. 11, n. 10, p. 1576-1585 How to Cite?
AbstractCopyright © 2014 by the American Thoracic Society. Rationale: Pulmonary complications are a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation.Objectives: The relationship between pretransplant pulmonary function tests (PFTs) and development of post-transplant pulmonary complications in children was studied.Methods: This is a retrospective single institution cohort study of 410 patients who underwent pretransplant PFT and were monitored to 10 years posttransplant.Measurements and Main Results: Pulmonary complications were observed in 174 (42%) patients. Children with pulmonary complications had significantly lower forced expiratory flow at 25-75% of vital capacity (P = 0.02) derived using conventional predicted equations for age, and the Global Lung Initiative-2012 predicted equations (P = 0.01). T-cell depletion (P = 0.001), acute grade 3-4 graft-versus-host disease (P = 0.008), and chronic graft-versus-host disease (P = 0.01) increased risk for pulmonary complications. Patients who had pulmonary complications had a 2.8-fold increased risk of mortality (P,0.0001). The cumulative incidence of death due to pulmonary complications was significantly higher in children who had low lung volumes, FRC less than 50% (P = 0.005), TLC less than 50% (P = 0.0002), residual volume less than 50% (P = 0.007), and T-cell depletion (P = 0.01). Lower FEV1 (P = 0.0005), FVC (P = 0.0005), TLC (P < 0.0001), residual volume less than 50% (P = 0.01), and restrictive lung disease (P = 0.01) predicted worse overall survival.Conclusions: Abnormal pretransplant PFT significantly increased risk after transplant. These patients may benefit from modified transplant strategies to reduce morbidity and mortality.
Persistent Identifierhttp://hdl.handle.net/10722/294501
ISSN
2015 SCImago Journal Rankings: 1.440
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorSrinivasan, Ashok-
dc.contributor.authorSrinivasan, Saumini-
dc.contributor.authorSunthankar, Sudeep-
dc.contributor.authorSunkara, Anusha-
dc.contributor.authorKang, Guolian-
dc.contributor.authorStokes, Dennis C.-
dc.contributor.authorLeung, Wing-
dc.date.accessioned2020-12-03T08:22:53Z-
dc.date.available2020-12-03T08:22:53Z-
dc.date.issued2014-
dc.identifier.citationAnnals of the American Thoracic Society, 2014, v. 11, n. 10, p. 1576-1585-
dc.identifier.issn2325-6621-
dc.identifier.urihttp://hdl.handle.net/10722/294501-
dc.description.abstractCopyright © 2014 by the American Thoracic Society. Rationale: Pulmonary complications are a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation.Objectives: The relationship between pretransplant pulmonary function tests (PFTs) and development of post-transplant pulmonary complications in children was studied.Methods: This is a retrospective single institution cohort study of 410 patients who underwent pretransplant PFT and were monitored to 10 years posttransplant.Measurements and Main Results: Pulmonary complications were observed in 174 (42%) patients. Children with pulmonary complications had significantly lower forced expiratory flow at 25-75% of vital capacity (P = 0.02) derived using conventional predicted equations for age, and the Global Lung Initiative-2012 predicted equations (P = 0.01). T-cell depletion (P = 0.001), acute grade 3-4 graft-versus-host disease (P = 0.008), and chronic graft-versus-host disease (P = 0.01) increased risk for pulmonary complications. Patients who had pulmonary complications had a 2.8-fold increased risk of mortality (P,0.0001). The cumulative incidence of death due to pulmonary complications was significantly higher in children who had low lung volumes, FRC less than 50% (P = 0.005), TLC less than 50% (P = 0.0002), residual volume less than 50% (P = 0.007), and T-cell depletion (P = 0.01). Lower FEV1 (P = 0.0005), FVC (P = 0.0005), TLC (P < 0.0001), residual volume less than 50% (P = 0.01), and restrictive lung disease (P = 0.01) predicted worse overall survival.Conclusions: Abnormal pretransplant PFT significantly increased risk after transplant. These patients may benefit from modified transplant strategies to reduce morbidity and mortality.-
dc.languageeng-
dc.relation.ispartofAnnals of the American Thoracic Society-
dc.subjectPediatric-
dc.subjectPulmonary function-
dc.subjectPost-transplant complications-
dc.titlePre-hematopoietic stem cell transplant lung function and pulmonary complications in children-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1513/AnnalsATS.201407-308OC-
dc.identifier.pmid25387361-
dc.identifier.pmcidPMC5475428-
dc.identifier.scopuseid_2-s2.0-84920504064-
dc.identifier.volume11-
dc.identifier.issue10-
dc.identifier.spage1576-
dc.identifier.epage1585-
dc.identifier.issnl2325-6621-

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