Improving detection of Pulmonary Graft-vs-Host Disease to facilitate earlier intervention

Chronic Graft-vs-Host Disease affects 60% of Haematopoeitic Stem Cell Transplant (HSCT) survivors by 6 years after their transplant, affecting multiple organs including skin, liver, gastrointestinal tract and lungs. Gold standard for pulmonary GVHD diagnosis is abnormal spirometry and subsequent CT-based imaging. Pulmonary GVHD is estimated to affect 10% of all subjects post HSCT yet this incidence is a gross underestimate due to the insensitivity of spirometry to detect peripheral lung changes where this process arises. This leads to late diagnosis, poor response to treatment, and poor prognosis (2-year and 5-year survival of 60% and 50%, respectively). Better tools to detect and monitor pulmonary GVHD are urgently required. 

This research program builds on previous work highlighting the potential utility of novel peripheral airway function tests (multiple breath washout and oscillometry) in this setting. It will look at what we can learn from studies already performed by analysing both local data and pooled historical international data across 12 international centres (including both paediatric and adult data) – we will define the utility of these tools to detect pulmonary GVHD and their ability to provide earlier detection to facilitate earlier invention and improve outcomes. It will also explore novel applications of these tests in a prospective cohort to enhance detection further in the initial period post HSCT to predict and detect those at risk.

This research is led by Dr Tamara Blake. If you are interested in participating in this research, please contact Cathy Pendergrast.