Cancer Clinical Trial
Official title:
Airway Reactivity in Children Before and After Bone Marrow Transplantation
Background: Stem cell transplantation (SCT) is associated with pulmonary complications and
may lead to high morbidity and mortality. We encountered several children post-SCT with a
clinical picture suggestive of airway hyper-reactivity (AHR) and evidence of reversible
airway obstruction that was not reported pre-transplant. Our aim was to determine if SCT
induced AHR as assessed by methacholine challenge test (MCT) and to determine any
correlation between AHR and pulmonary complications.
Methods: Prospective study evaluating consecutive patients referred for SCT to the
Department of Pediatric Hemato-Oncology at Meyer Children's Hospital. Evaluation included
pulmonary function test and methacholine challenge test before and after the
transplantation, and assessment of pulmonary complications.
We encountered several children post SCT with clinical picture suggestive of airway
hyper-reactivity (AHR) by spirometric evidence of reversible airway obstruction that was not
reported pre transplantation. Our question was if AHR is present but undiagnosed pre BMT or
AHR is developed post transplantation.
Our aim was to determine if BMT induces AHR as assessed by methacholine challenge test (MCT)
and to determine a possible correlation between AHR and pulmonary complications. The study
was Prospective. Subjects: consecutive patients were referred for pulmonary function tests
(PFT's); MCT and clincical evaluation before SCT and were followed after transplantation for
at least a year. The study was approved by the ethics committee and parental consent was
obtained. Clnical evaluation included medical history: type of disease, previous
chemo/radiotherapy. Type of SCT was recorded (allogeneic/ autologous). respiratory
evaluation included: Respiratory history; previous asthma medications; allergy/ parental
smoking; Physical exam; CXR O2-Sat. on rest and exercise. PFT's included: Spirometry, lung
volumes, diffusion capacity; MCT prior and 2-6 months post SCT; Follow-up: 6-12 months post
SCT. Pulmonary complication: Any respiratory symptoms or signs: cough, SOB, hemoptysis,
hypoxemia; New chest radiological finding; Number of hospitalizations due to pulmonary
complications.
Statistics: Sample size-26 patients to detect an increase of 0.5SD in AHR with a power of
80%. No. of children with AHR before and after SCT.; Pulmonary complications and AHR:
hospitalizations for pulmonary complications and AHR.
;
Observational Model: Cohort, Time Perspective: Prospective
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