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- Publisher Website: 10.1513/AnnalsATS.201407-308OC
- Scopus: eid_2-s2.0-84920504064
- PMID: 25387361
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Article: Pre-hematopoietic stem cell transplant lung function and pulmonary complications in children
Title | Pre-hematopoietic stem cell transplant lung function and pulmonary complications in children |
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Authors | |
Keywords | Pediatric Pulmonary function Post-transplant complications |
Issue Date | 2014 |
Citation | Annals of the American Thoracic Society, 2014, v. 11, n. 10, p. 1576-1585 How to Cite? |
Abstract | Copyright © 2014 by the American Thoracic Society. Rationale: Pulmonary complications are a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation.Objectives: The relationship between pretransplant pulmonary function tests (PFTs) and development of post-transplant pulmonary complications in children was studied.Methods: This is a retrospective single institution cohort study of 410 patients who underwent pretransplant PFT and were monitored to 10 years posttransplant.Measurements and Main Results: Pulmonary complications were observed in 174 (42%) patients. Children with pulmonary complications had significantly lower forced expiratory flow at 25-75% of vital capacity (P = 0.02) derived using conventional predicted equations for age, and the Global Lung Initiative-2012 predicted equations (P = 0.01). T-cell depletion (P = 0.001), acute grade 3-4 graft-versus-host disease (P = 0.008), and chronic graft-versus-host disease (P = 0.01) increased risk for pulmonary complications. Patients who had pulmonary complications had a 2.8-fold increased risk of mortality (P,0.0001). The cumulative incidence of death due to pulmonary complications was significantly higher in children who had low lung volumes, FRC less than 50% (P = 0.005), TLC less than 50% (P = 0.0002), residual volume less than 50% (P = 0.007), and T-cell depletion (P = 0.01). Lower FEV1 (P = 0.0005), FVC (P = 0.0005), TLC (P < 0.0001), residual volume less than 50% (P = 0.01), and restrictive lung disease (P = 0.01) predicted worse overall survival.Conclusions: Abnormal pretransplant PFT significantly increased risk after transplant. These patients may benefit from modified transplant strategies to reduce morbidity and mortality. |
Persistent Identifier | http://hdl.handle.net/10722/294501 |
ISSN | 2023 Impact Factor: 6.8 2023 SCImago Journal Rankings: 2.012 |
PubMed Central ID |
DC Field | Value | Language |
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dc.contributor.author | Srinivasan, Ashok | - |
dc.contributor.author | Srinivasan, Saumini | - |
dc.contributor.author | Sunthankar, Sudeep | - |
dc.contributor.author | Sunkara, Anusha | - |
dc.contributor.author | Kang, Guolian | - |
dc.contributor.author | Stokes, Dennis C. | - |
dc.contributor.author | Leung, Wing | - |
dc.date.accessioned | 2020-12-03T08:22:53Z | - |
dc.date.available | 2020-12-03T08:22:53Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Annals of the American Thoracic Society, 2014, v. 11, n. 10, p. 1576-1585 | - |
dc.identifier.issn | 2325-6621 | - |
dc.identifier.uri | http://hdl.handle.net/10722/294501 | - |
dc.description.abstract | Copyright © 2014 by the American Thoracic Society. Rationale: Pulmonary complications are a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation.Objectives: The relationship between pretransplant pulmonary function tests (PFTs) and development of post-transplant pulmonary complications in children was studied.Methods: This is a retrospective single institution cohort study of 410 patients who underwent pretransplant PFT and were monitored to 10 years posttransplant.Measurements and Main Results: Pulmonary complications were observed in 174 (42%) patients. Children with pulmonary complications had significantly lower forced expiratory flow at 25-75% of vital capacity (P = 0.02) derived using conventional predicted equations for age, and the Global Lung Initiative-2012 predicted equations (P = 0.01). T-cell depletion (P = 0.001), acute grade 3-4 graft-versus-host disease (P = 0.008), and chronic graft-versus-host disease (P = 0.01) increased risk for pulmonary complications. Patients who had pulmonary complications had a 2.8-fold increased risk of mortality (P,0.0001). The cumulative incidence of death due to pulmonary complications was significantly higher in children who had low lung volumes, FRC less than 50% (P = 0.005), TLC less than 50% (P = 0.0002), residual volume less than 50% (P = 0.007), and T-cell depletion (P = 0.01). Lower FEV1 (P = 0.0005), FVC (P = 0.0005), TLC (P < 0.0001), residual volume less than 50% (P = 0.01), and restrictive lung disease (P = 0.01) predicted worse overall survival.Conclusions: Abnormal pretransplant PFT significantly increased risk after transplant. These patients may benefit from modified transplant strategies to reduce morbidity and mortality. | - |
dc.language | eng | - |
dc.relation.ispartof | Annals of the American Thoracic Society | - |
dc.subject | Pediatric | - |
dc.subject | Pulmonary function | - |
dc.subject | Post-transplant complications | - |
dc.title | Pre-hematopoietic stem cell transplant lung function and pulmonary complications in children | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1513/AnnalsATS.201407-308OC | - |
dc.identifier.pmid | 25387361 | - |
dc.identifier.pmcid | PMC5475428 | - |
dc.identifier.scopus | eid_2-s2.0-84920504064 | - |
dc.identifier.volume | 11 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | 1576 | - |
dc.identifier.epage | 1585 | - |
dc.identifier.issnl | 2325-6621 | - |