RT Journal Article
SR Electronic
T1 LATE-BREAKING ABSTRACT: Nitrogen multiple breath washout for diagnosis of biopsy-proven bronchiolitis obliterans in patients after allogeneic stem cell transplantation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA2009
DO 10.1183/13993003.congress-2016.OA2009
VO 48
IS suppl 60
A1 Luzia Baumeler
A1 Sylvia Nyilas
A1 Jörg Halter
A1 Spasenija Savic
A1 Anja Meyer
A1 Jakob Passweg
A1 Michael Tamm
A1 Philipp Latzin
A1 Daiana Stolz
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/OA2009.abstract
AB Bronchiolitis obliterans (BO) is one of the main causes of death after allogeneic stem cell transplantation (alloSCT). Chronic Graft-versus-Host Disease (cGvHD) is a risk factor for development of BO. Nitrogen multiple breath washout (N2-MBW) measures ventilation inhomogeneity, particularly in the small airways. The aim of this study was to compare N2-MBW and bodyplethysmography data with post alloSCT pulmonary outcome.Methods: This is a monocentric, cross-sectional cohort study. Unselected alloSCT recipients underwent N2-MBW and lung function during routine visits. Clinical, laboratorial and imaging data were collected. Based on cGvHD overall score, FEV1/VCmax and histology, they were categorized as: 1) low risk (FEV1/VCmax ≥70, cGvHD overall score 0; 2) high risk (FEV1/VCmax ≥70, cGvHD overall score 1-3; 3) bronchiolitis obliterans syndrome (BOS) (FEV1/VCmax <70, and, if performed, absent BO in histology) and 4) BO (histological proven lymphocytic or constrictive BO). The primary end-point was the Lung Clearance Index (LCI 2.5%).Results: 225 adults, age 52.8±12.3 y, underwent evaluation during routine visits within median (IQR) 5.4y (2.0-11) following alloSCT. Good quality data for at least one MBW measurement was obtained in 184 (82%) cases. Mean LCI2.5% differed significantly across groups (ANOVA, p= 0.001), increasing from low risk, to high risk, BOS and BO. In the BO group (n=23), LCI2.5% was clearly elevated above the upper limit of normal (> 8) in 96% of the patients, whereas FEV1/VCmax was decreased only in 57% of the cases.Conclusion: LCI2.5% is suggested to be more sensitive than FEV1/VCmax for diagnosing BO after alloSCT.