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

Enocson, Alexandra; Hubbard, Richard; McKeever, Tricia M.; Russell, Nigel; Byrne, Jennifer; Das-Gupta, Emma; Watson, Lynne; Fogarty, Andrew W.

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 (+6.0ppb, 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.

Citation

Enocson, A., Hubbard, R., McKeever, T. M., Russell, N., Byrne, J., Das-Gupta, E., Watson, L., & Fogarty, A. W. (2013). The acute impact of a hematopoietic allograft on lung function and inflammation: a prospective observational study. BMC Pulmonary Medicine, 13(Januar), Article 6. https://doi.org/10.1186/1471-2466-13-2

• Journal Article Type: Article
• Publication Date: Jan 11, 2013
• Deposit Date: Apr 10, 2014
• Publicly Available Date: Apr 10, 2014
• Journal: BMC Pulmonary Medicine
• Electronic ISSN: 1471-2466
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: Januar
• Article Number: 6
• DOI: https://doi.org/10.1186/1471-2466-13-2
• Keywords: Lung function, Inflammation, Haematopoietic transplant
• Public URL: https://nottingham-repository.worktribe.com/output/713048
• Publisher URL: http://www.biomedcentral.com/1471-2466/13/2