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Post-Transplant Events

Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT

Bone Marrow Transplantation volume 48, pages 814–818 (2013)Cite this article

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Abstract

To prospectively assess whether periodic chest health surveillance is beneficial for the early detection of bronchiolitis obliterans syndrome (BOS) in children after allo-SCT. Children up to 18 years of age receiving allo-SCT from September 2009 to September 2011 were included. Surveillance consisted of the following: a 7-item respiratory system questionnaire of cough, wheeze and shortness of breath; focused physical examination; and pulmonary function test (PFT) conducted before SCT and at 1, 3, 6, 9, 12, 18 and 24 months after SCT. Thirty-nine patients were enrolled. Five children developed BOS at a median time of 192 days (range 94–282). Positive response comparisons between the BOS group vs the non-BOS group were NS for history questionnaire (P=0.2), heart rate (P=0.3), respiratory rate (P=0.3) and oxygen saturation monitoring (P=0.8). Differences between the two groups for chest auscultation and PFT were statistically significant (P=0.03 and P=0.01, respectively). However, chest auscultation in the BOS group was only positive after BOS diagnosis. PFT reduction was evident in the asymptomatic phase (BOS group 33%; non-BOS group 4.5%, P=0.01). Changes in PFT, but not history/physical examination, allow the early detection of BOS in children after SCT. Our study is limited by the small sample size.

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Acknowledgements

AG is supported by an award from the Comprehensive Cancer Centre, Ontario, that funded the study. Also we are indebted to the patients and their families, nursing and medical staff of the BMT unit for the provision of excellent patient care and continuing support.

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Authors and Affiliations

  1. Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Ontario, Canada

    A Gassas, H Craig-Barnes, J Doyle, T Schechter, L Sung & M Egeler

  2. Programs of Physiology & Experimental Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Ontario, Canada

    H Craig-Barnes & L Sung

  3. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada

    H Craig-Barnes & N Palaniyar

  4. Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Ontario, Canada

    S Dell & N Palaniyar

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  1. A Gassas
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Correspondence to A Gassas.

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Gassas, A., Craig-Barnes, H., Dell, S. et al. Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT. Bone Marrow Transplant 48, 814–818 (2013). https://doi.org/10.1038/bmt.2012.228

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