Potential Early Risk Biomarkers for Reduced Forced Expiratory Volume in Children Post-Hematopoietic Cell
Isabella S Small1, Pi Chun Cheng2, April L Rahrig3
1Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Researchers identified potential early biomarkers for lung disease in children after allogeneic hematopoietic stem cell transplant (HCT). Higher levels of WFDC1, TNFR1, MMP-2, and SPD may predict reduced lung function post-transplant.
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.
Abstract:
We sought to identify potential early risk biomarkers for lung disease in children post-allogeneic HCT. Patients with pulmonary function tests 3 months post-transplant and plasma samples between days 7 and 14 post-HCT were included. Six of 27 subjects enrolled had reduced forced expiratory volume 1 (FEV1) z scores. Biomarker medians were higher in those with a reduced FEV1 z score ([WFDC1: 48,098 vs. 27,086 pg/mL, p = 0.062, AUC = 0.75], [TNFR1: 5,771 vs. 3,034 pg/ml, p = 0.078, AUC = 0.71], [MMP-2: 380 vs. 290 ng/mL, p = 0.065, AUC = 0.75] and [SPD: 19.0 vs. 10.3 ng/mL, p = 0.049, AUC = 0.77]). This hypothesis-generating study yields promising results for early risk biomarkers for lung disease post-HCT.
