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Sleep-related breathing disorder in non-infectious pulmonary complications after pediatric allogeneic stem cell transplantation |
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| Author: | Ukonmaanaho, Elli-Maija1,2; Kirjavainen, Turkka3; Martelius, Laura4; |
| Organizations: |
1Division of Pediatric Hematology and Oncology, Oulu University Hospital, Oulu, Finland 2University of Helsinki, Helsinki, Finland 3Division of Pediatric Pulmonology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
4Division of Radiology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Division of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland 6Division of Pathology, Helsinki University Hospital, Helsinki, Finland 7Division of Hematology-Oncology and Stem Cell Transplantation, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 3.8 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe20230825107575 |
| Language: | English |
| Published: |
Springer Nature,
2022
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| Publish Date: | 2023-08-25 |
| Description: |
AbstractBackground: Chronic lung problems are a rare but serious complication of allogeneic hematopoietic stem cell transplantation (HSCT). We studied clinical phenotypes and polysomnography appearance of breathing abnormality in late onset non-infectious pulmonary complications (NIPS). Methods: We reviewed Finnish national reference database between the years 1999 and 2016. We identified 12 children with most severely decreased pulmonary function and performed polysomnography and 24 aged-matched controls out of 325 performed pediatric allogeneic HSCTs. Results: All patients with NIPS had severely decreased pulmonary function already at 6 months post HSCT with median FEV1 value 42% (interquartile range (IQR) 30–52%) of predicted normal values. Seven children had obstructive and five children more restrictive lung function. Children with obstructive lung function showed laborious breathing (7/7), decreased oxygenation and ventilation-to-perfusion mismatch (6/7), or REM-sleep-related hypoventilation (4/7) on polysomnography. Children with restrictive lung function (5/12) did not show sleep-related breathing disorder. Conclusions: Children going through allogeneic HSCT who develop severe chronic obstructive lung function are more likely to present with sleep-related hypoxia and hypoventilation than children with restrictive lung function. Impact: Children with severe obstructive lung function and chronic lung graft-versus-host disease following hematopoietic stem cell transplantation are more likely to present with sleep-related mild hypoxia and hypoventilation than children with restrictive lung disease. To our knowledge there are no reports on sleep-related breathing disorders and ventilatory function measured by polysomnography in children with pulmonary complications after allogeneic HSCT. Polysomnography may add to the differential diagnostics between patients with BOS and other non-infectious pulmonary complications. see all
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| Series: |
Pediatric research |
| ISSN: | 0031-3998 |
| ISSN-E: | 1530-0447 |
| ISSN-L: | 0031-3998 |
| Volume: | 93 |
| Issue: | 7 |
| Pages: | 1983 - 1989 |
| DOI: | 10.1038/s41390-022-02339-7 |
| OADOI: | https://oadoi.org/10.1038/s41390-022-02339-7 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3123 Gynaecology and paediatrics 3121 General medicine, internal medicine and other clinical medicine |
| Subjects: | |
| Funding: |
This work was supported by Finnish Pediatric Cancer Foundation Väre, grant number 202000038, info@vareensaatio.fi; Finnish Pediatric Research Foundation, grant number 200166, lts@lastentautientutkimussaatio.fi; and Finnish Pediatric Cancer Foundation Aamu, grant number 201900022, info@aamusaatio.fi. Open Access funding provided by University of Helsinki including Helsinki University Central Hospital. |
| Dataset Reference: |
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. |
| Copyright information: |
© 2022 The Authors. This 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/. |
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https://creativecommons.org/licenses/by/4.0/ |