Table 2 Summary of the 30 studies included for PICO 1
Study Design Location Years | Number of subjects | Population enrolled | Key results |
|---|---|---|---|
Alonso-Riofrio 2004 Cohort Spain 1992–2002 | 77 | Patients surviving > 100 days post-aHSCT | Mean pre-aHSCT FEV1 = 97% predicted |
Bruno 2004 Cohort France 1984–2000 | 80 | Children receiving aHSCT | Only change in spirometry from baseline to 2 yrs reported |
Duncan 2008 Cohort US 2001–2005 | 216 | Children receiving aHSCT | Mean pre-aHSCT: FEV1 = 99% predicted FEV1/FVC = 90% predicted |
Friedman 2021 Cohort US 2012–2017 | 19 | Children with sickle cell disease 2 to 21-yo receiving aHSCT | Pre-aHSCT: 7 patients (41%) had FEV1 < 80% predicted, 3 (18%) had an FEV1/FVC < 0.80, 2 (12%) had a TLC < 80% predicted, and 11 (65%) had DLCO < 80% of predicted |
Gassas 2013 Cohort Canada 2009–2011 | 39 | Children receiving aHSCT | Mean pre-aHSCT FEV1 = 95% predicted |
Inaba 2010 Cohort US 1990–2005 | 89 | Children receiving aHSCT | Pre-aHSCT abnormalities (prevalence): FEV1 = 22%, FEV1/FVC = 18%, FEF25-75% = 17%, FVC = 16%, TLC = 12%, DLCO = 19% |
Isgro 2017 Cohort Nigeria 2010–2015 | 37 | Children with sickle cell disease receiving aHSCT | Pre-aHSCT: 11/25 (44%) had restrictive pattern 18/25 (72%) had reduced FEV1 |
Jung 2021 Cohort South Korea 2006–2017 | 21 | Children with post-aHSCT BOS | Pre-aHSCT mean ± SD: FEV1 = 93 ± 13% predicted FVC = 88 ± 15% predicted FEF25-75% = 113 ± 24% predicted |
Kaplan 1992 Cohort US 1977–1988 | 46 | Children receiving mostly aHSCT whose long- term PFT data were available | Pre-aHSCT < 80% predicted: FVC = 24%, FEV1 = 27%, and FEV1/FVC = 29% |
Kaplan 1994 Cohort (divided into aplastic anemia and malignancy) US 1977–1988 | 46 | Children receiving mostly aHSCT whose long- term PFT data were available | Pre-aHSCT < 80% predicted: FVC = 6–9%, FEV1 = 13–27%, FEV1/FVC = 9–20%, FEF25-75% = 3–9% |
Kaya 2009 Cohort US 1996–2006 | 110 | Children receiving aHSCT | Pre-aHSCT abnormalities: FVC = 19%, FEV1 = 20%, FEV1/FVC = 13%, TLC = 9%, DLCO = 58% |
Kim 2021 Cohort South Korea 2009–2017 | 46 | Children post-aHSCT with obstructive lung disease | Pre aHSCT mean ± SD: FEV1 = 105% ± 25% (unfavorable prognosis) FEV1 = 106% ± 15% (favorable prognosis) |
Lee 2021 Cohort Korea 2010–2018 | 176 | Children > 6-yo receiving aHSCT for malignant disease | Pre-aHSCT DLCOadj was significantly lower in the non-relapse mortality (NRM) group compared to disease-related mortality (DRM) group (survivors = 76 ± 13%; DRM = 78 ± 15%; NRM = 62 ± 14%; p = 0.02) |
Madanat-Harjuoja 2014 Cohort Finland 1993–2005 | 51 | Children > 6-yo receiving aHSCT | 8 (16%) patients had an abnormal baseline PFT, 5 restrictive and 3 mild obstructive changes (all diagnosed with asthma) Prior to aHSCT, mean FVC = 93% predicted (range 60–121) and median was 92%; mean FEV1 = 95% (range 74–116) and median was 95%; mean FEV1/FVC = 0.98 (0.79–1.00) Patients with abnormal pre-aHSCT spirometry result were at increased risk of abnormal spirometry result following transplant (HR 4.82, 95% CI 1.02 – 22.84) |
Nysom 1996 Cohort Denmark Before 1990 | 25 | Children receiving aHSCT | Almost all had below normal pre-aHSCT FEV1/FVC, FVC, or DLCO |
Park 2011 Cohort South Korea 2002–2009 | 127 | Children receiving aHSCT | Mean pre-aHSCT FEV1 = 101% predicted |
Piesiak 2013 Cohort Poland 2007–2010 | 23 | Children/adults receiving aHSCT | 6/23 (26%) had abnormalities: 4 in DLCO, 1 obstructive, and 3 restrictive Mean pre-aHSCT percent predicted: FEV1 = 81%, FVC = 87%, FEV/FVC = 84%, DLCO = 85%, TLC = 81%, RV = 121% |
Prais 2014 Cohort Israel 1998–2008 | 57 | Children > 6-yo receiving mostly aHSCT | 27% had abnormal pre-transplant spirometry: 9% obstructive, 7% restrictive, 11% isolated diffusion abnormality Mean percent predicted values FEV1 = 91%, FVC = 87%, FEV1/FVC = 91%, FEF25-75 = 105%, DLCO = 88% |
Quigg 2012 Cohort US 2001–2006 | 41 | Children 5 to 19-yo receiving aHSCT | 71% had one or more abnormal PFT parameters pre-aHSCT: 22% obstructive, 34% low DLCOadj and DLCOadj/VA |
Sanchez 1997 Cohort Spain 1981–1995 | 20 | Children post-aHSCT with obstructive lung disease | Normal spirometry before aHSCT |
Srinivasan 2014 Cohort US 1990–2009 | 410 | Children receiving aHSCT | Abnormal spirometry pre-aHSCT: FEV1 = 15% (7% had FEV1 < 70% predicted), FVC = 16% (6% had FVC < 70% predicted), FEF25-75% = 28% (13% had FEF25-75% <70% predicted), TLC 29% (12% had TLC < 70% predicted). 3% DLCO was < 50% predicted 5% had obstructive pattern, 27% restrictive pattern, 2% mixed Logistic regression analysis: each unit decrease in FEF25–75% resulted in a threefold increased risk of developing pulmonary complications (P = 0.02) Multivariate analysis: RV < 50% predicted, FRC < 50% predicted, TLC < 50% predicted, and T-cell depletion predicted death due to pulmonary complications Multivariate analysis: FEV1 < 70% predicted, FVC < 70% predicted, TLC < 60% predicted, RV < 50%, and the presence of restrictive pattern associated with poor survival |
Srinivasan 2017 Cohort US 1990–2009 | 410 | Children receiving aHSCT | Only change in spirometry from baseline reported |
Uderzo 2007 Cohort Italy 1994–1997 | 162 | Children receiving aHSCT | 21/99 (21%) had abnormal pre-aHSCT spirometry |
Uhlving 2013 Cohort Denmark 1990–2010 | 130 | Children receiving aHSCT | Pre-aHSCT FEV1 abnormal in 26% |
Uhlving 2015 Case-control Denmark 2002–2009 | 128 (64 cases) | Cases: children < 16-yo receiving aHSCT Controls: healthy children/adults | Only change in spirometry from baseline reported |
Uhlving 2019 Cohort Denmark 2010–2012 | 30 | Children between 3 to 16-yo who underwent aHSCT | Pre-aHSCT: 13% abnormal FEV1, 70% abnormal DLCO Abnormal FEV1 pre-aHSCT gave OR of 12.0 (95% CI 0.8-177.4) for developing BO/BOS |
Versluys 2015 Cohort Netherlands 2008–2013 | 142 | Children who underwent aHSCT | 66% had pre-aHSCT spirometry Mean pre-aHSCT percent predicted: FEV1 = 83%, FVC = 87%, TLC = 86%, DLCO = 81% |
Walther 2020 Cohort Germany 2000–2017 | 14 | Children with post-aHSCT BOS | Spirometry normal before aHSCT |
Wieringa 2005 Cohort Netherlands 2001–2003 | 39 | Children undergoing aHSCT | Only change in spirometry from baseline reported |
Yoon 2015 Cohort South Korea 2009–2012 | 110 | Children undergoing aHSCT | Pre-aHSCT mean ± SD: FEV1 = 102 ± 16% Abnormal in 6% of patients |