Background: Spirometry is insensitive for detecting bronchiolitis obliterans syndrome (BOS) in allo-HSCT recipients. Multiple breath nitrogen washout (MBNW) is sensitive to peripheral airway dysfunction and may be useful for early detection. Aim: To compare changes in MBNW indices and spirometry in the 1st year following allo-HSCT. Method: Allo-HSCT recipients of the Haematology Department at Royal North Shore Hospital, Sydney underwent spirometry and MBNW measurements of acinar (Sacin), conductive (Scond) and global (LCI) peripheral airway function. Tests were performed pre-allo-HSCT and at 3 monthly intervals. A decline in FEV1 of ≥10% led to monthly testing. A pooled analysis using a semi-parametric linear mixed-effects model (gamm f(x), R-statistics) was used to compare relative changes in spirometry and MBNW indices from pre-transplant values. Results: 65 allo-HSCT recipients [35M/30F] were studied, of (mean±SD) age 50.3±13 yrs, BMI 26±5kg/m², FEV1 101±15%pred, FEV1/FVC 79±6.6, Sacin L-1 0.10±0.05, Scond L-1 0.03±0.02, LCI 8.6±1.1 and mean(range) smoking history 6(0-50) pack yrs. At 1 year post allo-HSCT, Sacin increased by 42% [p<0.0001], Scond by 5% [p=0.49] and LCI by 4% [p=0.16]. There was a 6% [p=0.18] fall in FEV1. The deterioration in Sacin was significantly greater than that of FEV1 [p<0.01]. Conclusion: In the first year following allo-HSCT, Sacin was the only MBNW parameter that changed significantly, whilst FEV1 remained unchanged. Future work is needed to determine Sacin's correlation with clinical parameters such as GVHD scores, and its ability to predict the onset of BOS.
|Number of pages||1|
|Journal||European Respiratory Journal|
|Issue number||suppl 60|
|Publication status||Published - 1 Sep 2016|
|Event||European Respiratory Society (ERS) International Congress 2016 - London, United Kingdom|
Duration: 3 Sep 2016 → 7 Sep 2016