Pretransplant Small-airway Dysfunction is Associated with Posttransplant Complications in Adult HSCT Recipients.
- 1Division of Pulmonary Medicine, Marmara University Faculty of Medicine, İstanbul, Türkiye.
- 2Division of Hematology, Marmara University Faculty of Medicine, İstanbul, Türkiye.
Abstract
Objective
Pulmonary function testing is routinely performed before hematopoietic stem cell transplantation (HSCT), but conventional parameters may not capture subtle airway abnormalities. This study evaluated the association of pretransplant forced expiratory flow between 25% and 75% of forced vital capacity (FEF₂₅₋₇₅) with post-HSCT complications in adults.Material and methods
This retrospective single-center cohort included 83 adults who underwent HSCT between 2016 and 2023. Reduced FEF₂₅₋₇₅ was defined as <75% predicted. The primary outcome was a composite of post-HSCT complications. Multivariable logistic regression models were adjusted for age, sex, ever-smoking status, HSCT type, and reduced forced expiratory volume in 1 second (FEV₁). Discrimination was assessed using receiver operating characteristic analysis.Results
Overall, 32 patients (38.6%) experienced post-HSCT complications. Complications occurred in 50.0% of patients with reduced FEF₂₅₋₇₅ versus 28.9% of those with FEF₂₅₋₇₅ ≥75% predicted (P = 0.049). Reduced FEF₂₅₋₇₅ was independently associated with higher odds of complications [odds ratio (OR): 3.58, 95% confidence interval (CI): 1.28-10.04; P = 0.015]. Reduced FEV₁ showed an inverse association (OR: 0.12, 95% CI: 0.02-0.71; P = 0.019). FEF₂₅₋₇₅ showed poor standalone discrimination (area under the curve: 0.578, 95% CI: 0.450-0.705).Conclusion
Reduced pretransplant FEF₂₅₋₇₅ was independently associated with post-HSCT complications, but showed poor standalone discrimination. These hypothesis-generating findings suggest that FEF₂₅₋₇₅ may provide information complementary to FEV₁, but they do not support its use as an independent predictive test. Larger prospective studies are required.
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BibTeX
@article{cınar2026pretransplant,
title = {{Pretransplant Small-airway Dysfunction is Associated with Posttransplant Complications in Adult HSCT Recipients.}},
author = {Caner Çınar and Ahmet Mert Yanık and Zeynep Mercancı and Cansu Yıldız and Tayfur Toptaş and Işık Atagündüz and Semiha Emel Eryüksel and Sait Karakurt},
journal = {Thoracic research and practice},
year = {2026},
month = oct,
doi = {10.4274/thoracrespract.2026.2026-5-9},
url = {https://europepmc.org/article/MED/42840756},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Pretransplant Small-airway Dysfunction is Associated with Posttransplant Complications in Adult HSCT Recipients.
AU - Caner Çınar
AU - Ahmet Mert Yanık
AU - Zeynep Mercancı
AU - Cansu Yıldız
AU - Tayfur Toptaş
AU - Işık Atagündüz
AU - Semiha Emel Eryüksel
AU - Sait Karakurt
PY - 2026
DA - 2026/10/07
JO - Thoracic research and practice
DO - 10.4274/thoracrespract.2026.2026-5-9
UR - https://europepmc.org/article/MED/42840756
AB - Objective Pulmonary function testing is routinely performed before hematopoietic stem cell transplantation (HSCT), but conventional parameters may not capture subtle airway abnormalities. This study evaluated the association of pretransplant forced expiratory flow between 25% and 75% of forced vital capacity (FEF₂₅₋₇₅) with post-HSCT complications in adults.Material and methods This retrospective single-center cohort included 83 adults who underwent HSCT between 2016 and 2023. Reduced FEF₂₅₋₇₅ was defined as <75% predicted. The primary outcome was a composite of post-HSCT complications. Multivariable logistic regression models were adjusted for age, sex, ever-smoking status, HSCT type, and reduced forced expiratory volume in 1 second (FEV₁). Discrimination was assessed using receiver operating characteristic analysis.Results Overall, 32 patients (38.6%) experienced post-HSCT complications. Complications occurred in 50.0% of patients with reduced FEF₂₅₋₇₅ versus 28.9% of those with FEF₂₅₋₇₅ ≥75% predicted (P = 0.049). Reduced FEF₂₅₋₇₅ was independently associated with higher odds of complications [odds ratio (OR): 3.58, 95% confidence interval (CI): 1.28-10.04; P = 0.015]. Reduced FEV₁ showed an inverse association (OR: 0.12, 95% CI: 0.02-0.71; P = 0.019). FEF₂₅₋₇₅ showed poor standalone discrimination (area under the curve: 0.578, 95% CI: 0.450-0.705).Conclusion Reduced pretransplant FEF₂₅₋₇₅ was independently associated with post-HSCT complications, but showed poor standalone discrimination. These hypothesis-generating findings suggest that FEF₂₅₋₇₅ may provide information complementary to FEV₁, but they do not support its use as an independent predictive test. Larger prospective studies are required.
SN - 2979-9139
ER -