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[Lung function changes after haematopoietic stem cell transplantation]
T de la Calle Cabrera1, J R Villa Asensi, M González Vicent
1Servicios de Neumofisiología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. teresacalle1@hotmail.com
Insights
Children undergoing hematopoietic stem cell transplantation (HSCT) often experience early lung function abnormalities. While lung function partially recovers by 24 months, it may not reach pre-transplant levels.
Area of Science:
- Pediatric Pulmonology
- Hematology
- Transplantation Medicine
Background:
- Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various pediatric conditions.
- Pulmonary complications are a significant concern following HSCT in children.
- Understanding lung function changes post-HSCT is crucial for patient management.
Purpose of the Study:
- To evaluate lung function abnormalities in children after HSCT.
- To compare pulmonary outcomes between autologous and allogenic HSCT.
- To assess the temporal pattern of lung function recovery post-transplantation.
Main Methods:
- Prospective observational study including 93 children undergoing HSCT (47 autologous, 46 allogenic).
- Lung function tests (FEV1, FEV1/FVC, TLC, DLCO) performed pre-HSCT and at 2, 6, 12, and 24 months post-HSCT.
- Paired Student's t-test used for statistical analysis.
Main Results:
- Significant reductions in FEV1/FVC, TLC, and DLCO observed at 2 months post-HSCT compared to baseline.
- Lung function showed gradual improvement from 6 months but did not fully recover by 24 months.
- No major differences in lung function between autologous and allogenic HSCT, except for lower FEV1/FVC in allogenic at 6 months.
Conclusions:
- A substantial proportion of children develop early pulmonary abnormalities after HSCT.
- Pulmonary function demonstrates partial recovery by 24 months post-transplantation.
- Close monitoring of lung function is essential for pediatric HSCT recipients.
Objective:
To evaluate lung function abnormalities in children who underwent haematopoietic stem cell transplantation (HSCT) and to compare these abnormalities between autologous and allogenic transplantation.
Patients And Methods:
Prospective observational study from 1996 to 2005. Ninety-three children receiving HSCT, 47 autologous and 46 allogenic, were included. Lung function tests were performed before transplantation and at 2, 6, 12 and 24 months afterwards. The following indices were determined: forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC), total lung capacity (TLC), and carbon monoxide diffusing capacity (DLCO). Paired Student's t-test was used for statistical analysis of data.
Results:
Before HSCT, 6.8% of the children had FEV1<80%, 1% FEV1/FVC<80%, 7.8% TLC<80% and 13.5% DLCO<70%. At 2 months, FEV1/FVC, TLC and DLCO were significantly reduced, when compared to pre-transplantation values (p=0.05, 0.011 and p<0.001, respectively). Lung function gradually improved from 6 months post-transplantation, but did not reach pre-transplantation values at 24 months. No significant differences were found when comparing allogenic and autologous transplantation, apart from a lower FEV1/FVC value at 6 months (p=0.02) in the first group.
Conclusions:
An important proportion of children who undergo HSCT have early pulmonary abnormalities (at 2 and 6 months after transplantation) with partial recovery at 24 months.
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