Detection of Post- Hematopoietic Stem Cell Transplant Bronchiolitis Obliterans Syndrome (BOS)-The Use of Airway Oscillometry.

IF 2.4 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2026-09-01 DOI:10.1002/ppul.71831

Samuel B Goldfarb, Richard Cooper, Jane Koo, Kasiani C Myers, Laura Walkup, Jason Woods, Eleanor Cook, Brian Hils, Adam Lane, Julian Allen, Stella M Davies, Christopher Towe

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引用次数: 0

Abstract

Background: Bronchiolitis obliterans syndrome (BOS) is a devastating complication of allogeneic hematopoietic stem cell transplantation (HSCT) characterized by onset of obstructive lung disease. Oscillometry is a novel pulmonary function assessment technology which superimposes pressure waves on normal tidal breathing, and the alterations in flow and pressure caused by the external waves are measured. Oscillometry assesses physiological parameters that provide insight into respiratory mechanics. We hypothesized that oscillometry may allow for detection of small airway disease to diagnose BOS, especially in children unable to perform spirometry.

Methods: We conducted a cross-sectional study to characterize oscillometry findings in patients with BOS compared to a control cohort of HSCT patients without BOS. PFT testing were performed on all patients at the time of oscillometry testing.

Results: Thirty-six patients post HSCT were approached, 18 with BOS and 18 controls. These two groups were similar in demographic parameters. BOS patients had significantly abnormal spirometry values. Oscillometry results demonstrated significant differences between the two cohorts in X5, AX, R5, R5-19 and (R5-19)/R5. There were significant differences between BOS and transplant control groups when assessing the association between oscillometry parameter and spirometry parameters.

Conclusion: In our cohort oscillometry revealed significant differences between the BOS and non- BOS cohort. Resistance at R5 Hz and the difference between R5-R19 Hz, which characterizes peripheral lung resistance, were both abnormally increased when compared with non- BOS subjects. In addition, reactance parameters, X5 and AX, which correlate with lung stiffness demonstrated significant differences between the BOS and non- BOS cohorts. Our data reveal a strong correlation between oscillometric and spirometric abnormalities in patients with established BOS originally identified by standard spirometry testing. In addition, oscillometry suggests localization of increased resistance in the lung periphery supporting our hypothesis that oscillometry might be complementary to spirometry, and enhance our ability to diagnose BOS.

Trial registration: ClinicalTrials.gov identifier: NCT04098445.

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造血干细胞移植后闭塞性细支气管炎综合征（BOS）的检测——气道振荡法的应用。

背景：闭塞性细支气管炎综合征（BOS）是同种异体造血干细胞移植（HSCT）的一种破坏性并发症，以阻塞性肺疾病为特征。振荡测量法是一种新的肺功能评估技术，它将压力波叠加在正常的潮汐呼吸上，测量外界波引起的流量和压力的变化。振荡测量法评估生理参数，为呼吸力学提供见解。我们假设振荡测量法可能允许检测小气道疾病来诊断BOS，特别是在无法进行肺活量测定的儿童中。方法：我们进行了一项横断面研究，将BOS患者的振荡测量结果与无BOS的HSCT患者的对照队列进行比较。所有患者在进行振荡测量时均进行PFT测试。结果：36例HSCT后患者接受了治疗，其中18例为BOS， 18例为对照组。这两组的人口学参数相似。BOS患者肺量测量值明显异常。振荡测量结果显示两个队列在X5、AX、R5、R5-19和(R5-19)/R5上存在显著差异。在评估振荡测量参数和肺活量测量参数之间的相关性时，BOS组与移植对照组之间存在显著差异。结论：在我们的队列中，振荡测量显示了BOS和非BOS队列之间的显著差异。与非BOS受试者相比，R5 Hz阻力和R5- r19 Hz之间的差异（表征外周肺阻力）均异常增加。此外，与肺刚度相关的电抗参数X5和AX在BOS组和非BOS组之间存在显著差异。我们的数据显示，在最初通过标准肺活量测定测试确定的BOS患者中，振荡测量和肺活量异常之间存在很强的相关性。此外，振荡测量法提示肺外周阻力增加的局限性，这支持了我们的假设，即振荡测量法可能是肺活量测定法的补充，并增强了我们诊断BOS的能力。试验注册：ClinicalTrials.gov标识符：NCT04098445。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.