Correlation and Agreement of Handheld Spirometry with Laboratory Spirometry in Allogeneic Hematopoietic Cell Transplant Recipients.

Publication Type:

Journal Article


Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (2015)


BACKGROUND: Early detection of subclinical lung function decline may help identify allogeneic hematopoietic cell transplantation (HCT) recipients who are at increased risk for late non-infectious pulmonary complications including bronchiolitis obliterans syndrome (BOS). We evaluated the use of handheld spirometry in this population.

METHODS: Allogeneic HCT recipients enrolled in a single center observational trial performed weekly spirometry with a handheld spirometer for one year after transplantation. Participants performed pulmonary function tests in an outpatient laboratory setting at 3 time points: pre-transplant, day 80 and 1 year post-transplant. Correlation between the two methods was assessed by Pearson and Spearman correlations; agreement was assessed using Bland-Altman plots.

RESULTS: A total of 437 subjects had evaluable pulmonary function tests. Correlation for FEV1 was r=0.954 (p<.0001) at day 80 and r=0.931 (p<.0001) at 1 year when the handheld and laboratory tests were performed within one day of each other. Correlation for handheld FEV6 with laboratory FVC was r=0.914 (p<.0001) at day 80 and r=0.826 (p<.0001) at 1 year. The bias, or the mean difference (handheld minus laboratory) for FEV1 at day 80 and 1 year was -0.13L (-0.63, 0.37) and -0.10L (-0.77, 0.56), respectively. FEV6 showed greater bias at day 80 [-0.51L (-1.44, 0.42)] and 1 year [-0.40L (-1.81, 1.01)].

CONCLUSIONS: Handheld spirometry correlated well with laboratory spirometry after allogeneic HCT and may be useful for self-monitoring of patients for early identification of airflow obstruction.