{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:09:56Z","timestamp":1780315796151,"version":"3.54.1"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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 Pulmonology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although survival for childhood acute lymphoblastic leukaemia (ALL) has improved, long\u2010term pulmonary function deficit remains a concern. We aimed to explore the prevalence of pulmonary function deficit and abnormal pulmonary function tests in childhood ALL survivors and clinical associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This national, retrospective cohort study (February 2019\u2013May 2024) included eligible 5\u201317.9\u2009year\u2010old survivors (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009295) who performed a valid pulmonary function test \u2265\u20091\u2009year after treatment (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009185). Clinical associations included treatment characteristics, pulmonary diagnosis, and radiological findings from medical charts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 185 survivors, 37% (95% confidence interval (CI): [30, 45]) had pulmonary function deficit, with the highest prevalence (56%) among 15\u201317.9\u2010year\u2010olds. Abnormal test prevalence was 37% [27, 48] for diffusing capacity (carbon monoxide and\/or nitric oxide), 29% [22, 38] for lung clearance index, 12% [8,18] for forced expiratory volume in the first second, and 11% [7, 17] for broncho\u2010dilator response. Bronchiolitis obliterans, stem cell transplantation and CT\u2010verified bronchiectasis were significant clinical associations of pulmonary function deficit (100%, 97.5% CI: [40, 100], 89% [76, 103], 73% [51, 96]) and abnormal diffusing capacity (100% (97.5% CI [29, 100]), 82% [59, 105], 75% [45, 105]), respectively. Bronchiectasis (88% [65, 110]) and transplantation (64% [39, 89]) were associated with a higher prevalence of abnormal lung clearance index. Bronchiolitis obliterans (75% [19, 99]) and transplantation (61% [39, 84]) were associated with a higher prevalence of abnormal forced expiratory volume in the first second.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pulmonary function deficit was frequent in childhood ALL survivors, especially after stem cell transplantation or pulmonary disease. Tailored long\u2010term pulmonary monitoring, including small airway function and diffusing capacity, may aid in timely detection and intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71600","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:20:42Z","timestamp":1776072042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Function Deficit and Clinical Associations in Childhood Acute Lymphoblastic Leukaemia Survivors: A National Retrospective ALL\u2010STAR Lungs Cohort Study"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-2196","authenticated-orcid":false,"given":"Sonja Izquierdo Riis","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Danish Centre of Paediatric Pulmonology and Allergology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte Klug","family":"Albertsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine, Centre for Paediatric and Adolescent Cancer Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette Tiedemann","family":"Skipper","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine, Centre for Paediatric and Adolescent Cancer Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Tuckuviene","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peder Skov","family":"Wehner","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology, H.C. Andersen Children's Hospital Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Leth","family":"Frandsen","sequence":"additional","affiliation":[{"name":"Mary Elizabeth's Hospital \u2013 Rigshospitalet for Children, Teens and Expecting Families, Juliane Marie Centre Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0829-4993","authenticated-orcid":false,"given":"Kjeld","family":"Schmiegelow","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liv","family":"Andr\u00e9s\u2010Jensen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5906-9449","authenticated-orcid":false,"given":"Kim Gjerum","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine, Danish Paediatric Pulmonary Service Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7010-2350","authenticated-orcid":false,"given":"Sune Leisgaard M\u00f8rck","family":"Rubak","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Danish Centre of Paediatric Pulmonology and Allergology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.265"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12562"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29833"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950240403"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2013.09.027"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31610-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.01.052"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25969"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26749"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10978"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2013.09.009"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.5.1163"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045543"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01519-2022"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25119"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201801-0074ST"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00069712"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00753-2019"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00016-2016"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00962-2016"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00904.2009"},{"key":"e_1_2_11_28_1","unstructured":"K.Houltz BG A.Lindblad F.Singer P.Robinson K.Nielsen andP.GustafssonTidal N2 Washout Ventilation Inhomogeneity Indices in a Reference Population Aged 7\u201370 Years. 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