Trends and Clinical Implications of Pediatric Pulmonary Function After Hematopoietic Stem Cell Transplantation: A Systematic Review

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Health Science Reports Pub Date : 2025-01-22 DOI:10.1002/hsr2.70365

Xiaowei Zhao, Yuqi Zhao, Guoyu Ding, Xue Li, Xiaoyue Zhang, Yanli Leng, Hongmei Wang

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Abstract

Background and Aims

Hematopoietic stem cell transplantation (HSCT) is a key therapeutic approach for pediatric patients with hematologic and non-hematologic disorders. However, post-transplant pulmonary complications remain a significant cause of morbidity and mortality. Pulmonary Function Tests (PFTs) are essential for the early detection of pulmonary dysfunction, yet their application in pediatric HSCT recipients has yielded inconsistent results. This review aims to assess the variations in pulmonary function post-HSCT and explore their clinical implications for pediatric patients.

Methods

A systematic review was conducted by analyzing studies published between 2000 and 2024, sourced from PubMed, Web of Science, CNKI, and Wan Fang databases. The review included cohort studies, randomized controlled trials, and case-control studies that assessed pulmonary function using standardized PFTs.

Results

Pulmonary dysfunction, particularly obstructive and restrictive ventilatory disorders, is common in pediatric HSCT recipients. Significant changes in PFT parameters, such as FEV1/FVC ratio and FEF25-75%, were observed. However, trends in post-transplant pulmonary function vary due to factors such as pre-transplant lung conditions, patient age, and treatment protocols. Innovative diagnostic methods, such as parametric response mapping (PRM) and multiple breath washout (MBW), show promise in enhancing early detection and management of pulmonary complications.

Conclusion

Monitoring pulmonary function is critical for the early identification of complications in pediatric HSCT recipients. Although standardized clinical guidelines are available, variability in PFT trends underscores the need for more refined diagnostic tools. Advanced diagnostic methods, like PRM and MBW, may improve early detection and help optimize the management of pulmonary dysfunction, ultimately improving long-term outcomes for pediatric patients.

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儿童造血干细胞移植后肺功能的发展趋势和临床意义：一项系统综述。

背景和目的：造血干细胞移植（HSCT）是儿科血液病和非血液病患者的关键治疗方法。然而，移植后肺部并发症仍然是发病率和死亡率的重要原因。肺功能测试（pft）对于肺功能障碍的早期检测至关重要，但其在儿童HSCT接受者中的应用产生了不一致的结果。本综述旨在评估hsct后肺功能的变化，并探讨其对儿科患者的临床意义。方法：对2000 - 2024年间发表的研究进行系统回顾分析，数据来源为PubMed、Web of Science、CNKI和万方数据库。该综述包括队列研究、随机对照试验和病例对照研究，这些研究使用标准化PFTs评估肺功能。结果：肺功能障碍，特别是阻塞性和限制性通气障碍，在儿童HSCT受者中很常见。FEV1/FVC比值、FEF25-75%等PFT参数变化显著。然而，移植后肺功能的变化趋势因移植前肺部状况、患者年龄和治疗方案等因素而异。创新的诊断方法，如参数反应映射（PRM）和多次呼吸冲洗（MBW），在加强肺部并发症的早期发现和管理方面显示出希望。结论：监测肺功能对于早期识别儿童造血干细胞移植患者的并发症至关重要。虽然标准化的临床指南是可用的，但PFT趋势的可变性强调需要更精细的诊断工具。先进的诊断方法，如PRM和MBW，可以提高早期发现和帮助优化肺功能障碍的管理，最终改善儿科患者的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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