This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Bone marrow transplantation (BMT) in infants and children has been a life-saving cure in many young patients with various hematologic disorders, metabolic disorders, or malignancies. Pulmonary complications in older children occur during both the pre-procedure treatment and the post-BMT period (1;2). The pulmonary system of infants may be particularly at risk for complications due to the unique susceptibility of developing infant lungs to the toxic effects of radiation treatments (including total body irradiation (TBI)), and selected chemotherapy agents. BMT leads to both short term and long term changes in lung function. Numerous studies have documented lung function changes in both adults and in those children old enough to perform pulmonary function testing with forced expiratory flows. There have only been few studies evaluating the short-term effects of BMT in infants. Similar studies evaluating forced respiratory flows in infants before and after BMT have not been performed. Recent advancements in infant pulmonary function testing have made it possible to accurately measure several lung function variables, including air flow after forced expiration, in patients less than two years of age. This protocol is a prospective, longitudinal, observational study of pulmonary function in infants less than two years of age who have received a bone marrow transplant. Each subject will undergo infant pulmonary function testing at enrollment (before the BMT procedure, if possible, to obtain baseline measurements of pulmonary function) and at 3, 6 and 12 months post-procedure. Measurements at each visit will include expiratory flows from raised lung volumes, fractional lung volumes, partial expiratory flows from functional residual capacity (FRC), tidal breathing, and passive respiratory mechanics.
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