Bronchiolitis Obliterans
Conditions
Brief summary
This study investigates a type of cell, called abnormal clonogenic epithelial cells, in patients with bronchiolitis obliterans syndrome who have had an donor stem cell transplant or a lung transplant. Learning more about clonogenic cells in these patients may help doctors to detect signs of bronchiolitis obliterans syndrome earlier in future patients.
Detailed description
PRIMARY OBJECTIVE: I. To characterize epithelial cell phenotypes in allogeneic hematopoietic cell transplant (allo-HCT) recipients at MD Anderson Cancer Center (MDACC) and in lung transplant recipients at Houston Methodist who have bronchiolitis obliterans syndrome (BOS). OUTLINE: Patients undergo collection of blood samples and 3 brushings of the airway during standard of care (SOC) bronchoscopy. After the bronchoscopy, patients undergo 2 nasal brushings (swabs). Patients' medical records are also reviewed for data collection. After completion of study, patients are followed for up to 1 year.
Interventions
PROCEDUREBiospecimen Collection
Undergo collection of blood, airway brushings.
OTHERMedical Chart Review
Patients' medical records are reviewed
Sponsors
M.D. Anderson Cancer Center
National Institute of Allergy and Infectious Diseases (NIAID)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Allo-HCT recipients undergoing a bronchoscopy at MDACC who consent to undergoing study airway brushings in addition to clinically indicated bronchoscopic procedures (e.g. bronchoalveolar lavage) * 5 patients with advanced BOS - forced expiratory volume in one second (FEV1) =\< 75% predicted and meeting other National Institutes of Health (NIH) criteria (FEV1/forced vital capacity \[FVC\] ratio 0.7, presence of air trapping or graft versus host disease \[GVHD\] of another organ) * 5 patient with early BOS - at least 10% decline in FEV1 from baseline values, with FEV1 \>= 75% predicted, and 1 high-risk feature: * Active systemic chronic GVHD with new early airflow obstruction OR * Respiratory viral infection in last three months with resolution of viral symptoms but new airflow obstruction * 3 patients with no pulmonary impairment (FEV1 within 5% of baseline values) * Lung allograft recipients undergoing a bronchoscopy at Houston Methodist who consent to undergoing study airway brushing sin addition to clinically indicated bronchoscopy procedures * 5 patients with BOS Stage 2 or higher (\>= 35% decline in FEV1 from baseline values) * 5 patient with BOS Stage 0p or 1 (10-35% decline in FEV1 from baseline values) * 3 patients undergoing screening bronchoscopy without decline in FEV1 * patients with undiagnosed lung cancer and chronic obstructive pulmonary disease diagnosed by pulmonary function testing (FEV1/FVC less than the lower limit of normal with \>20 pack-year history of smoking)
Exclusion criteria
* Bronchoscopy performed on emergency basis for life-threatening issues as opposed to routine diagnostic testing * Patient unwilling to give consent for study airway brushings
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of abnormal epithelial cells between patients with bronchiolitis obliterans syndrome and those without | Up to 1 year | The relationship between the proportion of abnormal cells and degree of air trapping and lung abnormalities will be described through simple correlation. Exploration of non-linear relationships or rank-based summaries will be considered as appropriate. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of epithelial cell populations in allogeneic hematopoietic cell transplant recipients and lung graft recipients | Up to 1 year | The relationship between the proportion of abnormal cells and degree of air trapping and lung abnormalities will be described through simple correlation. Exploration of non-linear relationships or rank-based summaries will be considered as appropriate. |
Countries
United States
Contacts
CONTACTAjay Sheshadri
PRINCIPAL_INVESTIGATORAjay Sheshadri
M.D. Anderson Cancer Center
Outcome results
None listed