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Br J Nurs. 2019 Oct 10;28(18):1196-1200. doi: 10.12968/bjon.2019.28.18.1196.

Monitoring lung function in patients with chronic graft versus host disease: a pilot study.

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at time of writing was Clinical Nurse Specialist Photopheresis, The Rotherham NHS Foundation Trust, Rotherham.
Research Assistant, The Rotherham NHS Foundation Trust, Rotherham.
Consultant Haematologist, The Rotherham NHS Foundation Trust, Rotherham.
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield.


Bronchiolitis obliterans syndrome (BOS) following allogenic haematopoietic stem cell transplant is considered the manifestation of chronic graft versus host disease (cGvHD) in the lung, and affects about 14% of patients with cGvHD, mainly in the first 2 years after transplant. Despite advances in assessment, diagnosis and treatment, the clinical prognosis remains poor for patients with pulmonary manifestations of cGvHD. A pilot study of 50 patients was devised to establish whether a relationship exists between forced expiratory volume in 1 second (FEV1) via pulmonary function test (PFT) and the equivalent peak expiratory flow (PEF) via peak flow handheld spirometry in cGvHD patients receiving extracorporeal photopheresis (ECP). Only PEF observed within 2 days of PFT could be compared with data at month 3, 6, 9 and 12. This pilot study illustrated that monitoring via handheld peak flow readings has the potential to become an acceptable method of monitoring lung function longitudinally in cGvHD patients.


Chronic graft versus host disease; Extracorporeal photopheresis; Peak flow; Pulmonary function test; Spirometry

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