Enocson, Alexandra, Hubbard, Richard, McKeever, Tricia M., Russell, Nigel, Byrne, Jennifer, Das-Gupta, Emma, Watson, Lynne and Fogarty, Andrew W.
  
(2013)
The acute impact of a hematopoietic allograft on lung function and inflammation: a prospective observational study.
    BMC Pulmonary Medicine, 13
       (Januar).
    
     6/1-6/6.
     ISSN 1471-2466
  
  
  
  
  
  
    
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    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.
  
  
  
  
  
  
  
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