Trial Information

Airway Reactivity in Children Before and After Bone Marrow Transplantation

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.