Evidence map›Paper›PMID 40155876›Full record

SynthesisBMC pediatrics2025

Pulmonary function testing in pediatric allogeneic stem cell transplant recipients to monitor for Bronchiolitis obliterans syndrome: a systematic review.

William A Gower, Maximiliano Tamae-Kakazu, Shivanthan Shanthikumar, Saumini Srinivasan, Erin E Reardon, Amisha V Barochia, Edward Charbek, Charlotte Calvo, Pi Chun Cheng, Shailendra Das and 6 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

William A GowerDivision of Pediatric Pulmonology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. gower@email.unc.edu.
Maximiliano Tamae-KakazuDivision of Pulmonary and Critical Care, Michigan State University College of Human Medicine and Spectrum Health, Grand Rapids, MI, USA.
Shivanthan ShanthikumarRespiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.
Saumini SrinivasanDepartment of Pediatrics, University of Tennessee College of Medicine and Le Bonheur Children's Hospital, Memphis, TN, USA.
Erin E ReardonWoodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA.
Amisha V BarochiaLaboratory of Asthma and Lung Inflammation, Critical Care Medicine and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Edward CharbekDepartment of Internal Medicine, Saint Louis University, St Louis, MO, USA.
Charlotte CalvoPediatric Hematology and Immunology Department, Robert Debré Academic Hospital, GHU APHP Nord - Université de Paris, Paris, France.
Pi Chun ChengDivision of Pediatric Pulmonology, Allergy, and Sleep Medicine, Riley Hospital for Children, Indianapolis, IN, USA.
Shailendra DasDepartment of Pediatrics, Division of Pulmonary Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Stella M DaviesDivision of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Jessica GrossDivision of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Ajay SheshadriDepartment of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Christoper T ToweDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Samuel B GoldfarbDepartment of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Narayan P IyerDivision of Neonatology, Fetal and Neonatal Institute, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBronchiolitis obliterans syndrome (BOS) represents a significant source of morbidity and non-relapse mortality among children and young adults treated with allogeneic hematopoietic stem cell transplantation (aHSCT). Pulmonary function testing (PFT) pre- and post-aHSCT may allow for pre-symptomatic detection of BOS, and thus early intervention. Current guidelines and practices vary regarding which tests to perform and timing relative to transplant. A systematic review evaluating PFT before and after pediatric aHSCT was conducted to inform American Thoracic Society clinical practice guidelines on detection of BOS.

objectiveTo determine the optimal approach to conducting PFT prior to and after pediatric aHSCT. STUDY

designWe performed a systematic review of the literature to identify studies of PFT in human aHSCT recipients < 25 years of age to address two questions: (1) Should pre-transplant screening PFT be performed in pediatric patients who will undergo aHSCT? (2) At what frequency should pediatric patients who have had aHSCT undergo PFT? We searched in Medline through August 2022 for studies that enrolled patients < 25 years of age being treated with aHSCT for whom PFT data were reported before or after transplant.

resultsThe 30 studies with pre-transplant PFT data showed a wide range of findings, with the majority demonstrating abnormalities. In studies reporting respiratory symptoms, 85-100% of patients were asymptomatic. In the 21 studies reporting post-transplant PFT, 11 used a surveillance strategy where at least one test was performed in the first year post-transplant. Median time to BOS diagnosis was 6-12 months in the regular surveillance studies, and 6-24 months in the others. Forced expiratory volume in one second at the time of BOS diagnosis was 38-84% predicted in studies with regular surveillance versus 44-57% predicted in studies with no surveillance. In the surveillance group, BOS was identified in some patients who were asymptomatic. Data quality in studies reviewed was moderate to very low.

conclusionsAbnormalities in PFT are common in children prior to aHSCT. Regular monitoring in the first 1-2 years post-aHSCT may improve early and/or pre-symptomatic identification of BOS, but significant limitations may still be seen at the time of diagnosis. Higher quality data are needed.

Indexed as

Bronchiolitis ObliteransHematopoietic Stem Cell TransplantationRespiratory Function TestsAdolescentBronchiolitis Obliterans SyndromeChildHumansTransplantation, HomologousBronchiolitis obliterans syndromepediatricsStem cell transplantation

Identifiers

PMID40155876
PMCPMC11951628

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.