Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?

yegin, zeynep arzu; SUYANI, Elif; OZKURT, ZÜBEYDE NUR; AYDOĞDU, MÜGE; Yıldırım, Fatma; AKİ, Şahika Zeynep; Kokturk, Nurdan; TÜRKÖZ SUCAK, Gülsan; OĞUZÜLGEN, İPEK KIVILCIM

Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?

Nurdan KÖKTÜRK, (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Cerrahi Bölümü, Ankara, Türkiye)

Fatma YILDIRIM, (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Cerrahi Bölümü, Ankara, Türkiye)

Müge AYDOĞDU, (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Şahika Zeynep AKİ, (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Zeynep Arzu YEĞİN, (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Zübeyde Nur ÖZKURT, (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Elif SUYANI, (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

İpek KIVILCIM OĞUZÜLGEN, (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Cerrahi Bölümü, Ankara, Türkiye)

Gülsan TÜRKÖZ SUCAK (Gazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Hematology

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Yıl: 2016 Cilt: 33 Sayı: 1 Sayfa Aralığı: 34 - 40 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?

Öz:

Amaç: Hematopoetik kök hücre nakli (HKHN) hastalarında, nakil öncesi kemoterapi/radyoterapi etkisi ile oluşan serbest oksijen radikalleri ve reaktif oksijen türevleri pek çok nakil ilişkili erken ve geç pulmoner ve nonpulmoner komplikasyonun oluşmasında rol oynamaktadır. Ekshale nitrik oksit (NO) düzeyindeki artışın hava yollarındaki oksidatif stresi ve enflamasyonu yansıttığı ileri sürülmektedir. Bu prospektif çalışmada amacımız HKHN hastalarında nakil öncesi bakılan ekshale NO düzeylerinin nakil sonrası gelişen pulmoner komplikasyonlar ve sağkalım üzerine etkisinin araştırılması idi.Gereç ve Yöntemler: Ekim 2009-Temmuz 2011 tarihleri arasında HKHN uygulanan hastalar prospektif olarak çalışmaya alındılar. Nakil öncesi ekshalasyon havasında NO ölçümleri NIOX MINO® cihazı ile yapıldı. Bütün hastalar transplantasyon sonrası prospektif olarak anemnez, fizik muayene, akciğer filmi ve solunum fonksiyon testleri ile pulmoner komplikasyon açısından takip edildi.Bulgular: Çalışmaya yaş ortalamaları 45±13 yıl olan 40'ı (71%) erkek toplam 56 hasta (33 otolog, 23 allojeneik) dahil edildi. Nakil öncesi ekshale NO düzeyi tüm grupta 24±13 ppb (ortalama ± standart sapma) bulundu. Allojeneik HKHN uygulanan hastalarda ekshale NO düzeyi 19±6 ppm; otolog nakil uygulananlarda 27±15 ppm olarak bulundu (p=0,042). Nakil öncesi uygulanan kemoterapi ve radyoterapi rejimleri ile bazal NO düzeyleri arasında anlamlı korelasyon bulunmadı (p>0,05). Nakil sonrası pulmoner toksisite 12 (%21) hastada saptandı. Bazal NO değeri ile pulmoner toksisite arasında anlamlı ilişki saptanmadı. Tüm çalışma grubunda sağkalım oranı %70 olarak bulundu. Nakil öncesi ekshale NO düzeyinin sağ kalım üzerinde etkisinin olmadığı görüldü (eksitus grubunda 19±7 ppm, taburcu grubunda 26±15 ppm, p=0,114). Sonuç: HKHN hastalarında nakil öncesi ekshale NO ölçümü nakil sonrası pulmoner komplikasyon gelişimini ve mortaliteyi öngörmede kullanılabilir gözükmemektedir.

Anahtar Kelime:

Konular: Hücre ve Doku Mühendisliği Hematoloji Hücre Biyolojisi

Hematopoetik Kök Hücre Nakli Uygulanan Hastalarda Nakil Öncesi Ekshale Nitrik Oksit Düzeyi ile Pulmoner Komplikasyonları ve Mortaliteyi Öngörmek Mümkün müdür?

Öz:

Objective: Chemo/radiotherapy-induced free oxygen radicals and reactive oxygen derivatives contribute to the development of early and late transplantation-related pulmonary and extra-pulmonary complications in hematopoietic stem cell transplantation (HSCT) recipients. It has been proposed that an increase in fractional exhaled nitric oxide (FeNO) level indicates oxidative stress and inflammation in the airways. The aim of this prospective study is to evaluate the pretransplantation FeNO levels in HSCT patients and to search for its role in predicting post-transplantation pulmonary complications and mortality. Materials and Methods: HSCT patients were included in the study prospectively between October 2009 and July 2011. Pre-transplantation FeNO levels were measured with a NIOX MINO® device prior to conditioning regimens. All patients were monitored prospectively for post-transplantation pulmonary complications with medical history, physical examination, chest X-ray, and pulmonary function tests.Results: A total of 56 patients (33 autologous, 23 allogeneic) with mean age of 45±13 years were included in the study, among whom 40 (71%) were male. Pre-transplantation FeNO level of the whole study group was found to be 24±13 (mean ± standard deviation) parts per billion (ppb). The FeNO level in allogeneic HSCT recipients was 19±6 ppb while it was 27±15 ppb in autologous HSCT recipients (p=0.042). No significant correlation was found between the pre-transplantation chemotherapy and radiotherapy protocols and baseline FeNO levels (p>0.05). Posttransplantation pulmonary toxicity was identified in 12 (21%) patients and no significant relationship was found between baseline FeNO levels and pulmonary toxicity. The survival rate of the whole study group for 1 year after transplantation was 70%. No significant relationship was identified between baseline FeNO values and survival (FeNO 19±7 ppb in patients who died and 26±15 ppb in the survivors; p=0.114). Conclusion: Pre-transplantation FeNO measurement does not seem to have a role in predicting post-transplantation pulmonary complications and mortality.

Anahtar Kelime:

Konular: Hücre ve Doku Mühendisliği Hematoloji Hücre Biyolojisi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Kokturk N, Yıldırım F, AYDOĞDU M, AKİ Ş, yegin z, OZKURT Z, SUYANI E, OĞUZÜLGEN İ, TÜRKÖZ SUCAK G (2016). Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. , 34 - 40.
Chicago	Kokturk Nurdan,Yıldırım Fatma,AYDOĞDU MÜGE,AKİ Şahika Zeynep,yegin zeynep arzu,OZKURT ZÜBEYDE NUR,SUYANI Elif,OĞUZÜLGEN İPEK KIVILCIM,TÜRKÖZ SUCAK Gülsan Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. (2016): 34 - 40.
MLA	Kokturk Nurdan,Yıldırım Fatma,AYDOĞDU MÜGE,AKİ Şahika Zeynep,yegin zeynep arzu,OZKURT ZÜBEYDE NUR,SUYANI Elif,OĞUZÜLGEN İPEK KIVILCIM,TÜRKÖZ SUCAK Gülsan Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. , 2016, ss.34 - 40.
AMA	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. . 2016; 34 - 40.
Vancouver	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. . 2016; 34 - 40.
IEEE	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G "Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?." , ss.34 - 40, 2016.
ISNAD	Kokturk, Nurdan vd. "Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?". (2016), 34-40.

APA	Kokturk N, Yıldırım F, AYDOĞDU M, AKİ Ş, yegin z, OZKURT Z, SUYANI E, OĞUZÜLGEN İ, TÜRKÖZ SUCAK G (2016). Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. Turkish Journal of Hematology, 33(1), 34 - 40.
Chicago	Kokturk Nurdan,Yıldırım Fatma,AYDOĞDU MÜGE,AKİ Şahika Zeynep,yegin zeynep arzu,OZKURT ZÜBEYDE NUR,SUYANI Elif,OĞUZÜLGEN İPEK KIVILCIM,TÜRKÖZ SUCAK Gülsan Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. Turkish Journal of Hematology 33, no.1 (2016): 34 - 40.
MLA	Kokturk Nurdan,Yıldırım Fatma,AYDOĞDU MÜGE,AKİ Şahika Zeynep,yegin zeynep arzu,OZKURT ZÜBEYDE NUR,SUYANI Elif,OĞUZÜLGEN İPEK KIVILCIM,TÜRKÖZ SUCAK Gülsan Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. Turkish Journal of Hematology, vol.33, no.1, 2016, ss.34 - 40.
AMA	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. Turkish Journal of Hematology. 2016; 33(1): 34 - 40.
Vancouver	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?. Turkish Journal of Hematology. 2016; 33(1): 34 - 40.
IEEE	Kokturk N,Yıldırım F,AYDOĞDU M,AKİ Ş,yegin z,OZKURT Z,SUYANI E,OĞUZÜLGEN İ,TÜRKÖZ SUCAK G "Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?." Turkish Journal of Hematology, 33, ss.34 - 40, 2016.
ISNAD	Kokturk, Nurdan vd. "Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels?". Turkish Journal of Hematology 33/1 (2016), 34-40.