TY - JOUR

T1 - Surfactant protein D is associated with pulmonary manifestations of chronic graft-versus-host disease following hematopoietic stem cell transplantation

AU - Krarup, Anne Mols

AU - Kielsen, Katrine

AU - Uhlving, Hilde Hylland

AU - Steffensen, Rudi

AU - Sørum, Maria Ebbesen

AU - Nielsen, Kim Gjerum

AU - Buchvald, Frederik F.

AU - Sorensen, Grith L.

AU - Müller, Klaus Gottlob

N1 - Funding Information: This study was supported by The Danish Cancer Society. The authors alone are responsible for the content and writing of the paper.

PY - 2024

Y1 - 2024

N2 - Impairment of pulmonary function is reported in around 60% of children after allogeneic hematopoietic stem cell transplantation (HSCT), used as a treatment of high-risk acute leukemias and severe hematological disorders.1 The decline in pulmonary function is transient in most patients, but 5%–10% of children undergoing HSCT develop bronchiolitis obliterans (BO), which is a severe manifestation of chronic graft-versus-host disease (cGvHD). This progressive obstructive airway disease has a 5-year mortality rate of 33%–55% and may lead to permanent severe disability in a large proportion of those who survive.2 While early diagnosis and immunosuppressive treatment of BO may improve the prognosis, initial symptoms are often mild, and regular monitoring with spirometry is therefore important in the follow-up after HSCT. Importantly, however, young children below 5 years of age cannot cooperate to spirometry and reliable measurements may be hard to obtain even in older patients. Therefore, early predictive biomarkers of pulmonary GvHD are highly needed to guide clinical decisions.

AB - Impairment of pulmonary function is reported in around 60% of children after allogeneic hematopoietic stem cell transplantation (HSCT), used as a treatment of high-risk acute leukemias and severe hematological disorders.1 The decline in pulmonary function is transient in most patients, but 5%–10% of children undergoing HSCT develop bronchiolitis obliterans (BO), which is a severe manifestation of chronic graft-versus-host disease (cGvHD). This progressive obstructive airway disease has a 5-year mortality rate of 33%–55% and may lead to permanent severe disability in a large proportion of those who survive.2 While early diagnosis and immunosuppressive treatment of BO may improve the prognosis, initial symptoms are often mild, and regular monitoring with spirometry is therefore important in the follow-up after HSCT. Importantly, however, young children below 5 years of age cannot cooperate to spirometry and reliable measurements may be hard to obtain even in older patients. Therefore, early predictive biomarkers of pulmonary GvHD are highly needed to guide clinical decisions.

KW - bronchiolitis obliterans

KW - graft-versus-host disease

KW - hematopoietic stem cell transplantation

KW - Surfactant protein D

U2 - 10.1002/ppul.26836

DO - 10.1002/ppul.26836

M3 - Comment/debate

C2 - 38206069

AN - SCOPUS:85181883583

VL - 59

SP - 1103

EP - 1107

JO - Pediatric pulmonology. Supplement

JF - Pediatric pulmonology. Supplement

SN - 1054-187X

IS - 4

ER -