Ukonmaanaho, EM., Kirjavainen, T., Martelius, L. et al. Sleep-related breathing disorder in non-infectious pulmonary complications after pediatric allogeneic stem cell transplantation. Pediatr Res 93, 1983–1989 (2023). https://doi.org/10.1038/s41390-022-02339-7
Sleep-related breathing disorder in non-infectious pulmonary complications after pediatric allogeneic stem cell transplantation
|Author:||Ukonmaanaho, Elli-Maija1,2; Kirjavainen, Turkka3; Martelius, Laura4;|
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
|Online Access:||PDF Full Text (PDF, 3.8 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe20230825107575
|Publish Date:|| 2023-08-25
Background: 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.
|Pages:||1983 - 1989|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
This work was supported by Finnish Pediatric Cancer Foundation Väre, grant number 202000038, firstname.lastname@example.org; Finnish Pediatric Research Foundation, grant number 200166, email@example.com; and Finnish Pediatric Cancer Foundation Aamu, grant number 201900022, firstname.lastname@example.org. Open Access funding provided by University of Helsinki including Helsinki University Central Hospital.
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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