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Exhaled nitric oxide and pulmonary complications after paediatric stem cell transplantation

T Fazekas1, P Eickhoff, A Lawitschka

  • 1St. Anna Children's Hospital, Kinderspitalgasse 6, 1090, Vienna, Austria. tamas.fazekas@stanna.at

European Journal of Pediatrics
|February 22, 2012
PubMed

Insights

Elevated exhaled nitric oxide (FeNO) levels 28 days after haematopoietic stem cell transplantation (HSCT) in children predict later pulmonary complications. FeNO may serve as a diagnostic tool for bronchial inflammation post-paediatric HSCT.

Area of Science:

  • Pediatric Pulmonology
  • Hematology/Oncology
  • Transplantation Medicine

Background:

  • Pulmonary complications are significant causes of morbidity and mortality following hematopoietic stem cell transplantation (HSCT).
  • Early identification of children at risk for post-transplant pulmonary complications is crucial for timely intervention.

Purpose of the Study:

  • To investigate whether exhaled nitric oxide (FeNO) levels measured early after HSCT in children can predict the development of pulmonary complications.
  • To assess the utility of FeNO as a diagnostic marker for hyperinflammatory responses in the bronchial epithelium post-paediatric HSCT.

Main Methods:

  • A prospective study involving 30 children (aged 4-18 years) undergoing HSCT.
  • FeNO levels were measured at 10 days before HSCT, and on days 0, +28, and +60 post-HSCT.
  • Pulmonary complications and lung function were monitored until day +100 post-HSCT.

Main Results:

  • Pre-transplant FeNO levels did not differ between children who did or did not develop post-transplant pulmonary complications.
  • FeNO levels were significantly higher on day 0 (mean 7 ppb) and day +28 (mean 13 ppb) in children who later developed pulmonary complications compared to those who did not.
  • Specifically, children with pulmonary complications after day +28 showed higher mean FeNO levels at 28 days post-HSCT.

Conclusions:

  • Elevated FeNO levels at 28 days post-HSCT are predictive of pulmonary complications occurring later in children.
  • FeNO measurement shows promise as a valuable diagnostic tool for assessing hyperinflammatory responses in the bronchial epithelium after paediatric HSCT.
Abstract

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