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Lung clearance index: a new measure of late lung complications of cancer therapy in children
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  • Giuseppe Fabio Parisi,
  • Emanuela Cannata,
  • Sara Manti,
  • Maria Papale,
  • Mariaclaudia Meli,
  • Giovanna Russo,
  • Andrea Di Cataldo,
  • Salvatore Leonardi
Giuseppe Fabio Parisi
University of Catania
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Emanuela Cannata
University of Catania
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Sara Manti
University of Catania
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Maria Papale
University of Catania
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Mariaclaudia Meli
University of Catania
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Giovanna Russo
University of Catania
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Andrea Di Cataldo
University of Catania
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Salvatore Leonardi
University of Catania
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Abstract

Introduction Childhood cancer survivors (CSs) might face an increased lifelong risk of lung function impairment. The Lung Clearance Index (LCI) has been described as being more sensitive than spirometry in the early stages of some lung diseases. The aim of this study was to evaluate this index in a cohort of patients with a history of childhood cancer for the first time. Materials and Methods We evaluated 57 off-treatment CSs aged 0–18 years old and 50 healthy controls (HCs). We used the multiple breath washout (MBW) method to study LCI and spirometry. Results CSs did not show any differences from the controls in ventilation homogeneity (LCI 6.78 ± 1.35 vs. 6.32 ± 0.44, P: ns) or lung function (FEV1 99.9 ± 11.3% vs. 103.0 ± 5.9% of predicted, P: ns; FVC 98.2 ± 10.3% vs. 101.1 ± 3.3% of predicted). LCI significantly correlated with the number of years since the last chemotherapy (r = 0.35, P < 0.05). Conclusions Our study describes the trend of LCI in a cohort of CSs and compares it with the results obtained from healthy controls. The results show that patients maintain both good values of respiratory function and good homogeneity of ventilation during childhood. Moreover, the LCI identifies the tendency toward pulmonary fibrosis, which is typical of adult CSs, at an earlier time than spirometry.

Peer review status:Published

19 Jul 2020Submitted to Pediatric Pulmonology
21 Jul 2020Submission Checks Completed
21 Jul 2020Assigned to Editor
25 Jul 2020Reviewer(s) Assigned
29 Aug 2020Review(s) Completed, Editorial Evaluation Pending
07 Sep 20201st Revision Received
08 Sep 2020Submission Checks Completed
08 Sep 2020Assigned to Editor
08 Sep 2020Reviewer(s) Assigned
10 Sep 2020Review(s) Completed, Editorial Evaluation Pending
11 Sep 2020Editorial Decision: Accept
14 Sep 2020Published in Pediatric Pulmonology. 10.1002/ppul.25071