小儿干细胞移植中的肺功能。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2024-11-01 DOI:10.1016/j.transproceed.2024.10.013

Panuwat Srichaisawat , Jitladda Deerojanawong , Chanthana Harnruthakorn

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引用次数: 0

摘要

背景：小儿造血干细胞移植通常会导致肺部并发症，但泰国有关肺功能的数据有限。本研究旨在评估肺功能，调查相关并发症，并确定与移植前后肺功能缺陷相关的临床因素：在这项回顾性队列研究中，我们重点关注1999年至2020年期间接受造血干细胞移植的6-18岁儿童，确保他们能获得肺功能检测结果：在48名患者中，移植前和移植后（2-8年）肺功能异常者分别占16.7%和18.8%，弥散性缺陷占20.8%和8.3%，阻塞性缺陷占4.2%和10.4%。16名患者（33.3%）出现肺部并发症，包括15例感染和1例阻塞性支气管炎。虽然移植前肺功能缺陷与具体特征无明显关联，但移植后肺部并发症与移植后肺功能缺陷相关（aOR = 4.11，95% CI = 1.23-13.64，P = .02）。在 6 名接受移植前后随访的患者中，有肺部并发症的患者的肺功能随着时间的推移出现了明显的下降，而没有肺部并发症的患者的肺功能则保持稳定或有所改善。然而，这两组之间的差异未达到统计学意义（P = .13-.76）：结论：小儿造血干细胞移植中普遍存在的肺功能缺陷和并发症凸显了密切监测肺功能的重要性。移植后肺部并发症与肺功能缺陷有关，表明肺功能随后可能出现下降趋势，需要进一步进行前瞻性验证。

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Pulmonary Function in Pediatric Stem Cell Transplantation

Background

Pediatric hematopoietic stem cell transplantation often results in pulmonary complications, yet limited data exist on pulmonary function in Thailand. This study aims to assess pulmonary function, investigating associated complications and identifying clinical factors linked to pre- and post-transplant pulmonary function defects.

Methods

In this retrospective cohort study, we focused on children aged 6-18 years who underwent hematopoietic stem cell transplantation between 1999 and 2020, ensuring accessible pulmonary function tests results.

Results

Among 48 patients, abnormal pulmonary function pre- and post-transplant (2-8 years) included a diffusion defect in 16.7% and 18.8%, a restrictive defect in 20.8% and 8.3%, and an obstructive defect in 4.2% and 10.4%, respectively. Pulmonary complications occurred in 16 patients (33.3%), including 15 infections and 1 case of bronchiolitis obliterans. While pretransplant pulmonary function defects were not significantly associated with specific characteristics, post-transplant pulmonary complications correlated with post-transplant pulmonary function defects (aOR = 4.11, 95% CI = 1.23-13.64, P = .02). Among the 6 patients with pre- and post-transplant follow-up, those with pulmonary complications showed a discernible decline in pulmonary function over time, while those without pulmonary complications remained stable or improved. However, the differences between these groups did not reach statistical significance (P = .13-.76).

Conclusions

Prevalent pulmonary function defects and complications in pediatric hematopoietic stem cell transplantation highlight the importance of close pulmonary function monitoring. Post-transplant pulmonary complications are associated with defects, suggesting a potential trend of a subsequent decline in lung function, warranting further prospective validation.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.