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Open Access Research article

The acute impact of a hematopoietic allograft on lung function and inflammation: a prospective observational study

Alexandra Enocson1, Richard Hubbard1, Tricia McKeever1, Nigel Russell2, Jennifer Byrne2, Emma Das-Gupta2, Lynne Watson2 and Andrew W Fogarty1*

Author Affiliations

1 Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building City Hospital, Nottingham NG5 1PB, UK

2 Bone Marrow Transplant Unit, Department of Haematology, Nottingham University Hospital (City Campus), Nottingham, NG5 1PB, UK

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BMC Pulmonary Medicine 2013, 13:2  doi:10.1186/1471-2466-13-2

Published: 11 January 2013

Abstract

Background

No studies have investigated the immediate impact of receiving an allogeneic hematopoietic stem cell transplant (HSCT) on pulmonary inflammation or lung function.

Methods

Using a prospective study design, we quantified the changes in these outcome measures in eligible adult individuals in the first six months after receiving an allogeneic hematopoietic stem cell transplant.

Results

Between January 2007 and December 2008, 72 patients were eligible to participate in the cohort, and of these 68 (94%) were included in the study. Compared to baseline, pulmonary inflammation as measured by exhaled nitric oxide increased after receiving a HSCT with the largest increment seen at three months (+6.0ppb, 95%CI: +0.4 to +11.5), and this was sustained at six months. Percent predicted forced expiratory volume in one second decreased over the same period, with the largest decrease observed at six weeks (−5.9%, 95% CI: -8.9 to −2.9), and this was also sustained over a six month period. Similar associations were observed for FVC. A larger increase in exhaled nitric oxide from baseline at six weeks and three months may be associated with decreased mortality (p=0.06, p=0.04 respectively).

Conclusion

Our data demonstrate that recipients of an allogeneic HSCT experience an increase in biomarkers of pulmonary inflammation and a decrease in lung function in the first six months after the procedure. If independently validated in other study populations, these observations could have potential as a prognostic biomarker for this patient group.

Keywords:
Lung function; Inflammation; Haematopoietic transplant