Mercy Atieno Oduor, Teresa Cherop Lotodo, Tyler Severance, Beatrice Jepngetich Melly, Austin Omondi, Indagala Ndenga, Diana Flora Namaemba, Yvette Oyollo, Kelvin Mogesa Manyega, Jennifer Morgan, John Oguda, Patrick Loehrer, Terry Vik
Expanding Myeloma Training and Care in Western Kenya Through the ECHO Model: The Pilot Phase
JCO global oncology
hematopoietic cell transplantation hct uses cytotoxic chemotherapy andor radiation followed intravenous infusion stem cells cure malignancies bone marrow failure inborn errors immunity hemoglobin metabolism lung injury known complication process due part disruption pulmonary microenvironment insults infection alloreactive inflammation cellular toxicity microorganisms immunity respiratory epithelium interact contribute lung injury uncertain limiting development prevention treatment strategies used 278 bronchoalveolar lavage bal fluid samples study lung microenvironment 229 pediatric patients undergone hct treated 32 childrens hospitals 2014 2022 leveraging paired microbiome human gene expression data identified highrisk bal compositions associated inhospital mortality p 0007 disadvantageous profiles included bacterial overgrowth neutrophilic inflammation microbiome contraction epithelial fibroproliferation profound commensal depletion viral staphylococcal enrichment lymphocytic activation cellular injury replicated independent cohort netherlands p 0022 addition broad array previously occult pathogens identified well strong link antibiotic exposure commensal bacterial depletion enrichment viruses fungi together lungimmune systemmicroorganism interactions clarify important drivers fatal lung injury pediatric patients undergone hct investigation needed determine personalized interpretation heterogeneous pulmonary microenvironments may used improve pediatric hct outcomes