Cargando…
The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation
BACKGROUND: Pulmonary chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a devastating complication and often diagnosed at a late stage when lung dysfunction is irreversible. Identifying patients before transplant who are at risk may off...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9746214/ https://www.ncbi.nlm.nih.gov/pubmed/36510158 http://dx.doi.org/10.1186/s12890-022-02278-3 |
_version_ | 1784849314377367552 |
---|---|
author | Yang, Lingyi Cheng, Jia Li, Fei Qian, Ruiqi Zhang, Xiuqin Jin, Song He, Xuefeng Xu, Ting Hu, Xiaohui Ma, Xiao Chen, Jia Zhu, Yehan Chen, Feng |
author_facet | Yang, Lingyi Cheng, Jia Li, Fei Qian, Ruiqi Zhang, Xiuqin Jin, Song He, Xuefeng Xu, Ting Hu, Xiaohui Ma, Xiao Chen, Jia Zhu, Yehan Chen, Feng |
author_sort | Yang, Lingyi |
collection | PubMed |
description | BACKGROUND: Pulmonary chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a devastating complication and often diagnosed at a late stage when lung dysfunction is irreversible. Identifying patients before transplant who are at risk may offer improved strategies to decrease the mortality. Bronchiolitis obliterans syndrome (BOS) is the typical manifestation of pulmonary cGVHD, which is clinically diagnosed by pulmonary function test (PFT). This study aimed to evaluate the predictive value of PFT pre-HSCT for BOS. METHODS: A single center cohort of 923 allo-HSCT recipients was analyzed, including 15 patients who developed pulmonary cGVHD. Kaplan–Meier method was used to analyze the 3 year progression free survival and 3 year overall survival (OS). A Cox regression model was applied for univariate and multivariate models. RESULTS: The 3 year cumulative incidence of pulmonary cGVHD was 2.04% (95% CI 1.00–3.08%). According to the cut-off values determined by receiver operator characteristic curve, higher ratio of forced expiratory volume during one second to forced vital capacity (FEV1/FVC) pre-HSCT was correlated to a lower incidence of pulmonary cGVHD [0.91% (95% CI 0.01–1.81%) vs. 3.61% (95% CI 1.30–5.92%), P < 0.01], and so as peak expiratory flow to predictive value (PEF/pred) [0.72% (95% CI 0–1.54%) vs. 3.74% (95% CI 1.47–6.01%), P < 0.01]. Multivariate analysis showed that FEV1/FVC (HR = 3.383, P = 0.047) and PEF/pred (HR = 4.426, P = 0.027) were independent risk factors for onset of BOS. Higher FEV1/FVC and PEF/pred level were related to a significantly decreased 3 year non-relapse mortality. The 3 year OS was superior in patients with higher PEF/pred [78.17% (95% CI 74.50–81.84%) vs. 71.14% (95% CI 66.08–76.20%), P = 0.01], while FEV1/FVC did not show significance difference. CONCLUSION: Our results suggested that PFT parameters such as PEF/pred and FEV1/FVC could be predictors for pulmonary cGVHD and even transplant outcomes before HSCT. |
format | Online Article Text |
id | pubmed-9746214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97462142022-12-14 The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation Yang, Lingyi Cheng, Jia Li, Fei Qian, Ruiqi Zhang, Xiuqin Jin, Song He, Xuefeng Xu, Ting Hu, Xiaohui Ma, Xiao Chen, Jia Zhu, Yehan Chen, Feng BMC Pulm Med Research BACKGROUND: Pulmonary chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a devastating complication and often diagnosed at a late stage when lung dysfunction is irreversible. Identifying patients before transplant who are at risk may offer improved strategies to decrease the mortality. Bronchiolitis obliterans syndrome (BOS) is the typical manifestation of pulmonary cGVHD, which is clinically diagnosed by pulmonary function test (PFT). This study aimed to evaluate the predictive value of PFT pre-HSCT for BOS. METHODS: A single center cohort of 923 allo-HSCT recipients was analyzed, including 15 patients who developed pulmonary cGVHD. Kaplan–Meier method was used to analyze the 3 year progression free survival and 3 year overall survival (OS). A Cox regression model was applied for univariate and multivariate models. RESULTS: The 3 year cumulative incidence of pulmonary cGVHD was 2.04% (95% CI 1.00–3.08%). According to the cut-off values determined by receiver operator characteristic curve, higher ratio of forced expiratory volume during one second to forced vital capacity (FEV1/FVC) pre-HSCT was correlated to a lower incidence of pulmonary cGVHD [0.91% (95% CI 0.01–1.81%) vs. 3.61% (95% CI 1.30–5.92%), P < 0.01], and so as peak expiratory flow to predictive value (PEF/pred) [0.72% (95% CI 0–1.54%) vs. 3.74% (95% CI 1.47–6.01%), P < 0.01]. Multivariate analysis showed that FEV1/FVC (HR = 3.383, P = 0.047) and PEF/pred (HR = 4.426, P = 0.027) were independent risk factors for onset of BOS. Higher FEV1/FVC and PEF/pred level were related to a significantly decreased 3 year non-relapse mortality. The 3 year OS was superior in patients with higher PEF/pred [78.17% (95% CI 74.50–81.84%) vs. 71.14% (95% CI 66.08–76.20%), P = 0.01], while FEV1/FVC did not show significance difference. CONCLUSION: Our results suggested that PFT parameters such as PEF/pred and FEV1/FVC could be predictors for pulmonary cGVHD and even transplant outcomes before HSCT. BioMed Central 2022-12-12 /pmc/articles/PMC9746214/ /pubmed/36510158 http://dx.doi.org/10.1186/s12890-022-02278-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Yang, Lingyi Cheng, Jia Li, Fei Qian, Ruiqi Zhang, Xiuqin Jin, Song He, Xuefeng Xu, Ting Hu, Xiaohui Ma, Xiao Chen, Jia Zhu, Yehan Chen, Feng The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title | The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title_full | The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title_fullStr | The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title_full_unstemmed | The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title_short | The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
title_sort | predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9746214/ https://www.ncbi.nlm.nih.gov/pubmed/36510158 http://dx.doi.org/10.1186/s12890-022-02278-3 |
work_keys_str_mv | AT yanglingyi thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chengjia thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT lifei thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT qianruiqi thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT zhangxiuqin thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT jinsong thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT hexuefeng thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT xuting thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT huxiaohui thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT maxiao thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chenjia thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT zhuyehan thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chenfeng thepredictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT yanglingyi predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chengjia predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT lifei predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT qianruiqi predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT zhangxiuqin predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT jinsong predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT hexuefeng predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT xuting predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT huxiaohui predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT maxiao predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chenjia predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT zhuyehan predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation AT chenfeng predictivevalueofpulmonaryfunctiontestbeforetransplantationforchronicpulmonarygraftversushostdiseaseafterallogeneichematopoieticstemcelltransplantation |