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One-year lung function change and variability post allogeneic hematopoietic stem cell transplantation.

Kaj E C Blokland1, Troy J Cross2, Fei Ni Hau3

  • 1Airway Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Macquarie Park, NSW, Australia; Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia.

Respiratory Medicine
|January 25, 2026
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Summary

Oscillometry shows promise for detecting small airway changes after allogeneic stem cell transplant (allo-HSCT), complementing spirometry. This can help identify pulmonary graft-versus-host disease (GvHD) earlier, improving patient outcomes.

Keywords:
Allogeneic haemopoietic stem-cell transplantationLongitudinal changeOscillometrySpirometryVariability

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Area of Science:

  • Pulmonary medicine
  • Hematology
  • Transplantation immunology

Background:

  • Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a vital treatment for hematologic disorders.
  • Pulmonary complications, including graft-versus-host disease (GvHD), can compromise allo-HSCT success.
  • Spirometry is standard for lung function monitoring but insensitive to small airway changes.

Purpose of the Study:

  • To assess longitudinal changes and variability in spirometry and oscillometry post-allo-HSCT.
  • To identify predictors of lung function changes following allo-HSCT.
  • To evaluate oscillometry's potential in detecting early small airway dysfunction.

Main Methods:

  • Retrospective analysis of spirometry and oscillometry data from 374 allo-HSCT patients.
  • Data collected between January 2015 and December 2023.
  • Comparison of lung function parameters between allo-HSCT recipients and controls.

Main Results:

  • Patients showed lower baseline FEV1 and FVC post-allo-HSCT compared to controls.
  • Oscillometry revealed worsening of Rrs5 and Xrs5, while FEV1 remained stable.
  • Severe chronic GvHD correlated with declines in FEV1/FVC and Xrs5 trajectory.
  • Discordant changes between spirometry and oscillometry suggest oscillometry detects early small airway issues.

Conclusions:

  • Oscillometry shows potential as a complementary tool for lung function monitoring post-allo-HSCT.
  • Early detection of small airway mechanics changes via oscillometry may aid in identifying pulmonary GvHD risk.
  • Improved monitoring could lead to earlier interventions and better long-term clinical outcomes.