Birgitta Versluijs

85 Pulmonary screening before hematopoietic cell transplantation in children considered a disproportional invasive procedure (n=7). In 2 children above the age of 5, PFT was not feasible because of developmental delay. In 1 patient, HRCT was omitted because of the risk of irradiation damage related to underlying disease (Fanconi anemia). PFT PFT were performed in 83 patients. This was 94% of all patients in whom we were able to perform these tests, according to age and developmental level. Results are shown in Table 2. We found PFT patterns of restrictive and obstructive lung disease as well as dif- fusion abnormalities with forced expiratory volume in 1 second, mean 82.7% (SD 11.5); forced vital capacity, mean 87.8% (SD 14.1); total lung capacity, 86% (SD 10.2); and lung diffusion capacity for CO, corrected for hemoglobin and alveolar volume, 81.9% (SD 18.5). Compared with the reference population with values of 100% (SD 12), all diffe- rences were statistically significant; with P values of < .0001. There was no difference in abnormalities in PFT between the different disease categories, see Table 2. HRCT Chest HRCT was performed in 137 (96%) patients. In 74 patients (55%), abnormalities were seen; in 63 of 74 patients (85%) these findings were “new” findings. In the group of patients without pretreatment with chemotherapy or immune deficiency, the incidence of HRCT abnormalities before HCT was significantly lower than in the other patients (Figure 1). In 18 patients (13%), clinically significant abnormalities were found. Four (3%) had lesions suspect for fungus. Fourteen patients (10%) showed other abnormalities, including bronchiectasis, pleural effusion, consolidations, and aspecific nodules > 1 cm. These were new findings in 8 of 14 patients (57%). Most clinically significant abnormal- ities were found in the subgroup of patients with immune deficiencies, but this did not reach statistical significance (Figure 1). BAL BAL was performed in 127 (90%) patients. Unfortunately, for logistic reasons, it was not always possible to do all microbial tests. Overall, in 47% of tested patients, 1 or more of the microbial tests were positive. Positive PCR for RV was found in 35 (31%) of tested pa- tients. Rhinovirus was the most frequently detected virus (Table 3). In 21 (17%) patients, we found microbial evidence of fungal colonization either with positive cultures or GM. In only 2 patients, a positive GM corresponded with a positive culture for Aspergillus; in 1 patient with a positive Aspergillus culture, GM from BAL was negative. The positive findings for the whole cohort are shown in Table 3. In patients under 5 years of age, the incidences of BAL abnormalities in general, RV positivity, and bacteria positivity were significant higher than in older patients (P values of .001, .01, and .0003 respectively). 5