The acute impact of a hematopoietic allograft on lung function and inflammation: a prospective observational study.

Abstract

BACKGROUND:

No studies have investigated the immediate impact of receiving an allogeneic hematopoietic stem cell transplant (HSCT) on pulmonary inflammation or lung function.

METHODS:

Using a prospective study design, we quantified the changes in these outcome measures in eligible adult individuals in the first six months after receiving an allogeneic hematopoietic stem cell transplant.

RESULTS:

Between January 2007 and December 2008, 72 patients were eligible to participate in the cohort, and of these 68 (94%) were included in the study. Compared to baseline, pulmonary inflammation as measured by exhaled nitric oxide increased after receiving a HSCT with the largest increment seen at three months (+6.0 ppb, 95%CI: +0.4 to +11.5), and this was sustained at six months. Percent predicted forced expiratory volume in one second decreased over the same period, with the largest decrease observed at six weeks (-5.9%, 95% CI: -8.9 to -2.9), and this was also sustained over a six month period. Similar associations were observed for FVC. A larger increase in exhaled nitric oxide from baseline at six weeks and three months may be associated with decreased mortality (p=0.06, p=0.04 respectively).

CONCLUSION:

Our data demonstrate that recipients of an allogeneic HSCT experience an increase in biomarkers of pulmonary inflammation and a decrease in lung function in the first six months after the procedure. If independently validated in other study populations, these observations could have potential as a prognostic biomarker for this patient group.

• Authors: Alexandra Enocson, Richard Hubbard, Tricia McKeever, Nigel Russell, Jennifer Byrne, Emma Das-Gupta, Lynne Watson, Andrew W Fogarty
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 13 Pg. 2 (Jan 11 2013) ISSN: 1471-2466 [Electronic] England
• PMID: 23311727 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Nitric Oxide

Topics

• Acute Disease
• Adult
• Breath Tests
• Female
• Forced Expiratory Volume (physiology)
• Hematologic Diseases (mortality, therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects, mortality)
• Humans
• Lung (immunology, physiology)
• Male
• Middle Aged
• Nitric Oxide (metabolism)
• Pneumonia (immunology, mortality, physiopathology)
• Predictive Value of Tests
• Proportional Hazards Models
• Prospective Studies
• Transplantation, Homologous
• Vital Capacity (physiology)