title: Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT.
abstract: To prospectively assess whether periodic chest health surveillance is beneficial for the early detection of bronchiolitis obliterans syndrome (BOS) in children after allo-SCT. Children up to 18 years of age receiving allo-SCT from September 2009 to September 2011 were included. Surveillance consisted of the following: a 7-item respiratory system questionnaire of cough, wheeze and shortness of breath; focused physical examination; and pulmonary function test (PFT) conducted before SCT and at 1, 3, 6, 9, 12, 18 and 24 months after SCT. Thirty-nine patients were enrolled. Five children developed BOS at a median time of 192 days (range 94-282). Positive response comparisons between the BOS group vs the non-BOS group were NS for history questionnaire (P=0.2), heart rate (P=0.3), respiratory rate (P=0.3) and oxygen saturation monitoring (P=0.8). Differences between the two groups for chest auscultation and PFT were statistically significant (P=0.03 and P=0.01, respectively). However, chest auscultation in the BOS group was only positive after BOS diagnosis. PFT reduction was evident in the asymptomatic phase (BOS group 33%; non-BOS group 4.5%, P=0.01). Changes in PFT, but not history/physical examination, allow the early detection of BOS in children after SCT. Our study is limited by the small sample size.
authors.affiliation: Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Ontario, Canada. adam.gassas@sickkids.ca
authors.forename: A
authors.initials: A
authors.lastname: Gassas
authors.forename: H
authors.initials: H
authors.lastname: Craig-Barnes
authors.forename: S
authors.initials: S
authors.lastname: Dell
authors.forename: J
authors.initials: J
authors.lastname: Doyle
authors.forename: T
authors.initials: T
authors.lastname: Schechter
authors.forename: L
authors.initials: L
authors.lastname: Sung
authors.forename: M
authors.initials: M
authors.lastname: Egeler
authors.forename: N
authors.initials: N
authors.lastname: Palaniyar
mesh_terms: D000293:Adolescent; D064591:Allografts; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012129:Respiratory Function Tests; D033581:Stem Cell Transplantation; D011795:Surveys and Questionnaires; D013997:Time Factors