Evaluation of pulmonary functions after hematopoietic stem cell transplantation in children

Abstract

Introduction: Pulmonary complications (PC) are significant causes of morbidity and mortality after hematopoietic stem cell transplantation (HSCT) in children. PC can occur due to infectious and noninfectious causes. In our study we aimed to evaluate pulmonary functions and complications in children after HSCT. Method: 23 children who underwent HSCT at Bahcesehir University, Pediatric Hematology Department between 2011-2014 were enrolled in the study. Demographic characteristics, spirometry tests, lung volumes, CO diffusion capacity, 6-minute walk test results and pulmonary complications were evaluated. Results: 17 patients (74%) were male, mean age was 10.4 ± 4.6 years. Age at HSCT was 8.0 ± 4.7 years, average time after HSCT was 2.4 ± 1.1 years. Indication for HSCT was thalassemia major in 11 patients, acute lymphoblastic leukemia in 5 patients, acute myeloid leukemia in 3 patients, aplastic anemia in 2 patients, severe combined immunodeficiency in one patient and dyskeratosis congenita in one patient. Infectious or noninfectious PC was observed in 12 (52.2%) children (pneumonia: 9 pts, bronchiolitis obliterans: 2 pts, restrictive lung disease: 1 pt). PC developed at mean 6 months (range 1-34 months) after transplantation. No significant diffference was observed in pulmonary function tests and 6-minute walk test results of patients with or without pulmonary complications. Conclusion: Our study showed that pulmonary complications are frequent after HSCT. Failure to demonstrate differences between groups may be due to the low number of cases. Close monitoring and identifying patients at risk is important since early diagnosis and treatment of PC reduces morbidity and mortality.