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Spirometry follow-up in young children with hemato-oncologic diseases
Ori Efrati1, Amos Toren, Hadar Duskin
1Pediatric Pulmonary Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel, 52621. ori.efrati@sheba.health.gov.il
Insights
Pulmonary function monitoring via spirometry is crucial for young hemato-oncologic patients. Early detection of airway disease can guide treatment and predict outcomes in children.
Area of Science:
- Pediatric Pulmonology
- Hematology-Oncology
- Respiratory Medicine
Background:
- Hemato-oncologic treatment frequently leads to severe pulmonary complications.
- Pulmonary function testing is standard for older children but often overlooked in younger patients.
- Assessing young children's lung function is vital for managing treatment-related risks.
Purpose of the Study:
- To evaluate airway disease severity using spirometry in hemato-oncologic children aged 3-7 years.
- To compare pulmonary function before and after treatment (over 3 years) against a healthy control group.
- To identify potential prognostic indicators for respiratory health in this pediatric population.
Main Methods:
- Conducted spirometry on 42 hemato-oncologic children (3-7 years old) before and up to 3 years post-treatment.
- Compared pulmonary function test results with those of age-matched healthy children.
- Analyzed airflow limitation severity using standard spirometry metrics (FEV1, FEV0.5, FEF25-75).
Main Results:
- Most children (38/42) exhibited only minor long-term airflow impairment.
- Eight children initially presented with severe airflow limitation before treatment.
- Four of these eight experienced further deterioration, linked to GVHD and bronchiolitis obliterans.
Conclusions:
- Spirometry monitoring is essential for young hemato-oncologic patients.
- Detecting airflow limitations early has significant prognostic implications.
- Regular pulmonary function assessment aids in managing respiratory complications and optimizing treatment strategies.
Background:
Treatment of hemato-oncologic patients is often associated with severe pulmonary complications. Pulmonary function is routinely evaluated in older children, whereas in young patients, forced spirometry measurements are infrequently performed.
Aim:
To assess severity of airway disease using forced spirometry measured prior to and after treatment (over 3 years) in hemato-oncologic children aged 3-7 years in comparison to a healthy population.
Material/Methods:
42-children (18-males; age 3-7 years old) with hemato-oncologic illnesses participated in the study. Spirometry was performed before the definitive treatment and up-to 3-years thereafter. Values were compared to those of healthy children of corresponding age.
Results:
Most children (n=38) showed only minor long term airflow impairment (z-scores of FEV1 at last measurement was -0.00 to -0.45 SD). Prior to definitive treatment eight children presented severe airflow limitation (z-score =-1.35 + or - 0.72; -1.61 + or - 0.66 and -2.49 + or - 0.34 for FEV1, FEV0.5; and FEF25-75 respectively). Four of eight children resumed normal pulmonary function; the spirometry values of the other four children further deteriorated, in association with GVHD and development of bronchiolitis obliterans.
Conclusions:
Our study suggests that it is important to follow spirometry in young children with hemato-oncologic diseases in order to detect these patients, whose condition may have prognostic implications for their treatment.
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