Potential Early Risk Biomarkers for Reduced Forced Expiratory Volume in Children Post-Hematopoietic Cell...

Area of Science:

• Pediatric Hematology/Oncology
• Pulmonology
• Transplantation Immunology

Background:

• Allogeneic hematopoietic stem cell transplant (HCT) can lead to significant pulmonary complications in children.
• Early identification of children at risk for lung disease post-HCT is crucial for timely intervention.
• Current methods for predicting lung disease risk after HCT are limited.

Purpose of the Study:

• To identify potential early risk biomarkers for the development of lung disease in pediatric patients following allogeneic HCT.
• To investigate the association between specific plasma biomarkers and pulmonary function at 3 months post-transplant.
• To evaluate the predictive value of these biomarkers for reduced lung function.

Main Methods:

• Prospective study including pediatric patients undergoing allogeneic HCT.
• Collection of plasma samples between days 7 and 14 post-HCT.
• Pulmonary function tests (PFTs) performed at 3 months post-transplant, with a focus on forced expiratory volume in 1 second (FEV1) z scores.

Main Results:

• Six out of 27 enrolled subjects exhibited reduced FEV1 z scores at 3 months post-transplant.
• Median levels of WFDC1, TNFR1, MMP-2, and SPD were significantly higher in patients with reduced FEV1 z scores.
• The identified biomarkers demonstrated promising areas under the curve (AUC) for predicting reduced lung function (WFDC1: 0.75, TNFR1: 0.71, MMP-2: 0.75, SPD: 0.77).

Conclusions:

• WFDC1, TNFR1, MMP-2, and SPD show potential as early risk biomarkers for lung disease in children post-allogeneic HCT.
• These biomarkers could aid in the early identification of at-risk pediatric patients, enabling proactive management.
• Further validation in larger cohorts is warranted to confirm these findings and establish clinical utility.