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Peripheral airway abnormalities are common in children post bone marrow transplantation

Geshani Jayasuriya, Greg King, Hiran Selvadurai, Melissa Gabriel, Per Gustaffson, Kate Hardaker, Brendan Kennedy, Steven Keogh, Ida O'Brien, Peter Shaw, Paul Robinson
European Respiratory Journal 2015 46: PA1269; DOI: 10.1183/13993003.congress-2015.PA1269
Geshani Jayasuriya
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
2Medicine, The University of Sydney, Sydney, Australia
3Airways Physiology and Imaging, The Woolcock Institute of Medical Research, Sydney, Australia
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Greg King
2Medicine, The University of Sydney, Sydney, Australia
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Hiran Selvadurai
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
2Medicine, The University of Sydney, Sydney, Australia
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Melissa Gabriel
4Oncology, The Children's Hospital at Westmead, Sydney, Australia
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Per Gustaffson
5Paediatrics, Central Hospital, Skövde, Sweden
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Kate Hardaker
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Brendan Kennedy
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Steven Keogh
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Ida O'Brien
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Peter Shaw
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Paul Robinson
1Respiratory, The Children's Hospital at Westmead, Sydney, Australia
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Abstract

Aim: Pulmonary complications are common following Bone Marrow Transplantation (BMT) but peripheral airway involvement may be underestimated by conventional lung function measures, such as spirometry. This study aimed to characterize peripheral airway function in children post BMT using Multiple Breath Washout (MBW) in comparison to standard lung function.

Methods: Cross sectional study of children following BMT at a single tertiary centre. Inclusion criteria included age ≥3 years, allogenoeic BMT, similar conditioning regimens and stability at the time of testing. Assessment included MBW (performed using simultaneous inert gas washout with SF6 and Helium) and conventional lung function. Non-parametric data displayed as median (range).

Results: 24 subjects have been recruited to date: 16 (67%) male, age 14.3 (4.3-18.6) years, tested at 4.8 (0.7-12.1) years post BMT. Spirometry was feasible in 15/24 (63%) of the cohort, with abnormal values present in 5/24 (21%) for FEV1 and 4/15 (17%) for FEF25-75. MBW was feasible in all subjects. Abnormal MBW parameters were observed in a greater proportion (18/24, 75%) vs. either FEV1 or FEF25-75 (p<0.05). The proportion with abnormality in SF6 MBW indices was greatest with Scond (0.034 (0.004-0.089), Upper limit of normal (ULN) 0.023, abnormal in 18/24, (75%) followed by LCI (7.52 (5.03-23.59), ULN 7.35, abnormal in 14/24, 58%) and Sacin (0.105 (0.056-0.463), ULN 0.121, abnormal in 8/24, 33%).

Conclusion: MBW offered improved feasibility, compared to spirometry, for lung function assessment. Peripheral airway involvement was present in the majority of the cohort, and was underappreciated by spirometry.

  • Physiology
  • Lung function testing
  • Children
  • Copyright ©ERS 2015
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Peripheral airway abnormalities are common in children post bone marrow transplantation
Geshani Jayasuriya, Greg King, Hiran Selvadurai, Melissa Gabriel, Per Gustaffson, Kate Hardaker, Brendan Kennedy, Steven Keogh, Ida O'Brien, Peter Shaw, Paul Robinson
European Respiratory Journal Sep 2015, 46 (suppl 59) PA1269; DOI: 10.1183/13993003.congress-2015.PA1269

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Peripheral airway abnormalities are common in children post bone marrow transplantation
Geshani Jayasuriya, Greg King, Hiran Selvadurai, Melissa Gabriel, Per Gustaffson, Kate Hardaker, Brendan Kennedy, Steven Keogh, Ida O'Brien, Peter Shaw, Paul Robinson
European Respiratory Journal Sep 2015, 46 (suppl 59) PA1269; DOI: 10.1183/13993003.congress-2015.PA1269
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