{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:34:43Z","timestamp":1787758483074,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thoracic air leak syndrome (TALS) is a rare but severe complication of pulmonary chronic graft\u2010versus\u2010host disease (pGvHD) after allogeneic hematopoietic stem cell transplantation (HSCT), associated with high mortality in adult population. Evidence regarding optimal management in pediatric, adolescent, and young adult patients is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective single\u2010center study on patients who developed radiologically confirmed TALS after allogeneic HSCT between 2010 and 2023. Patients were divided into Group A (surgical treatment) and Group B (conservative treatment). Primary outcomes were mortality rate and overall survival (OS) after TALS diagnosis. Secondary outcomes were clinical and radiologic risk factors associated with mortality and intensive care unit (ICU) admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen patients were included. Nine patients underwent surgical treatment and six patients underwent conservative treatment. Surgical management was not associated with a statistically significant survival benefit compared to conservative treatment (mortality rate 78% in Group A vs. 100% in Group B,\n                      <jats:italic>p<\/jats:italic>\n                      value 0.4857; OS 296 days in Group A vs. 102.5 days in Group B,\n                      <jats:italic>p<\/jats:italic>\n                      value 0.2331). Preexisting chronic hypoxia emerged as the strongest predictor of mortality and ICU admission and was the only independent predictor of ICU admission on multivariate analysis (odds ratio 21.12, 95% confidence interval 2.61\u2013278.5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TALS represents a manifestation of advanced pulmonary disease rather than a surgically reversible condition. Emergency surgical procedures remain essential in cases of acute respiratory compromise, but they do not appear to improve long\u2010term prognosis. Early identification and management of pulmonary cGvHD may be critical to preventing progression toward TALS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70451","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:46:51Z","timestamp":1784630811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thoracic Air Leak Syndrome After Hematopoietic Stem Cell Transplant in Pediatric, Adolescent, and Young Adult Population: A Surgical Dilemma"],"prefix":"10.1002","volume":"73","author":[{"given":"Alice","family":"Gismondi","sequence":"first","affiliation":[{"name":"Academy of Surgery Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Academy of Surgery Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-2726","authenticated-orcid":false,"given":"Giorgio","family":"Persano","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit General and Emergency Surgery Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0037-4534","authenticated-orcid":false,"given":"Cristina","family":"Martucci","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit General and Emergency Surgery Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit General and Emergency Surgery Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Pardi","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaminia","family":"Rivosecchi","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Di Paolo","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Boccieri","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology and Hemopoietic Stem Cell Transplant Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome 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